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Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis

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Abstract

Purpose

To undertake a meta-analysis of comparative data of laparoscopic versus open inguinal herniotomy in infants and children.

Methods

We searched MEDLINE, EMBASE, and The Cochrane Central Controlled Trials Registry for relevant randomized controlled trials and observational studies comparing laparoscopic with open inguinal hernia repair in children aged less than 19 years.

Results

Data on 2,699 children were identified from 10 comparative studies. Laparoscopic techniques were associated with a trend towards higher recurrence rate (OR = 1.81; 95% CI 0.89–3.67; p = 0.10), longer operative time for unilateral repairs (WMD = 10.23; 95% CI 8.82–11.64; p < 0.00001), and may be shorter operative time for bilateral repairs (WMD = −4.54; 95% CI −11.63 to 2.55; p = 0.21). There was a significant reduction in developing a contralateral metachronous inguinal hernia in the laparoscopic group (OR = 0.37; 95% CI 0.20–0.67; p = 0.001).

Conclusions

Laparoscopic inguinal herniotomy is significantly associated with longer operative time for unilateral cases and a reduction in metachronous hernia development. There was a trend towards higher recurrence rate for laparoscopic repairs and shorter operative time for bilateral cases. A well conducted randomized controlled trial is warranted to compare both approaches.

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Acknowledgments

I would like to thank Dr Khalid Alfaleh for his advice regarding some of the aspects of the methodology of this systematic review.

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Authors and Affiliations

  1. Faculty of Medicine, King Khalid University Hospital, King Saud University, P.O. Box 7805 (37), Riyadh, 11472, Saudi Arabia

    Abdulrahman Alzahem

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  1. Abdulrahman Alzahem
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Correspondence to Abdulrahman Alzahem.

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Alzahem, A. Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis. Pediatr Surg Int 27, 605–612 (2011). https://doi.org/10.1007/s00383-010-2840-x

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  • DOI: https://doi.org/10.1007/s00383-010-2840-x

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