Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair.

Authors:
Masahiro Zenitani
Masahiro Zenitani
Toyonaka Municipal Hospital
Ryuta Saka
Ryuta Saka
Hyogo College of Medicine
Japan
Takashi Sasaki
Takashi Sasaki
Graduate School of Medicine
Japan
Yuichi Takama
Yuichi Takama
Osaka University Graduate School of Medicine
Suita | Japan
Gakuto Tani
Gakuto Tani
Osaka Medical Center and Research Institute for Maternal and Child Health
Osaka | Japan
Natsumi Tanaka
Natsumi Tanaka
Tottori University
Takehisa Ueno
Takehisa Ueno
Osaka University Graduate School of Medicine
Japan
Yuko Tazuke
Yuko Tazuke
Osaka University Graduate School of Medicine
Japan

Asian J Endosc Surg 2018 Dec 18. Epub 2018 Dec 18.

Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Japan.

Introduction: This study aimed to compare the safety and efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC) and conventional open repair (OR) for inguinal hernia in infants younger than 6 months.

Methods: The medical records of 202 patients who had undergone LPEC or OR at an age younger than 6 months between 2010 and 2016 were reviewed. Patient characteristics and surgical outcomes were compared between LPEC and OR.

Results: In total, there were 120 LPEC (76 males, 44 females) and 83 OR (76 males, 7 females) cases. There were no differences in median age, median bodyweight, and presence of incarceration between the two groups (LPEC group: 3 months (range, 0-5 months), 5.7 kg (range, 2.3-9.6 kg), and 13.3%; OR group: 3 months (range, 1-5 months), 5.5 kg (range, 2.1-9.0 kg), and 12.0%). LPEC was completed in all cases without any intraoperative complications or open conversions. In the LPEC group, 60.0% of unilateral hernia patients had a contralateral patent processus vaginalis and underwent prophylactic closure. The incidence of metachronous contralateral hernia was significantly lower in the LPEC group than in the OR group (0% vs 10.0%, P < 0.01). Operative time was significantly shorter during LPEC than during OR (P < 0.01) for male patients. The recurrence rate was lower in the LPEC group (0.83%) than in the OR group (2.4%), but the difference was not significant.

Conclusion: The present data indicate that LPEC is comparable to OR in terms of safety and efficacy in infants younger than 6 months. Moreover, among the LPEC group, there were fewer incidences of metachronous contralateral hernia, and the procedure had a shorter operative time.

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December 2018
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References

(Supplied by CrossRef)
Morbidity after neonatal inguinal herniotomy
Phelps et al.
J Pediatr Surg 1997

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