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Pediatric Inguinal Hernia: Laparoscopic Versus Open Surgery

BACKGROUND AND OBJECTIVES: Herniotomy/open surgery (OS) has been the time honored treatment for pediatric inguinal hernia (PIH). Laparoscopic surgery (LS) has recently emerged as an alternative in its management. However, controversy is rife on its feasibility and wider adoption. The present need is...

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Autores principales: Saranga Bharathi, Ramanathan, Arora, Manu, Baskaran, Vasudevan
Formato: Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015882/
https://www.ncbi.nlm.nih.gov/pubmed/18765052
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author Saranga Bharathi, Ramanathan
Arora, Manu
Baskaran, Vasudevan
author_facet Saranga Bharathi, Ramanathan
Arora, Manu
Baskaran, Vasudevan
author_sort Saranga Bharathi, Ramanathan
collection PubMed
description BACKGROUND AND OBJECTIVES: Herniotomy/open surgery (OS) has been the time honored treatment for pediatric inguinal hernia (PIH). Laparoscopic surgery (LS) has recently emerged as an alternative in its management. However, controversy is rife on its feasibility and wider adoption. The present need is to know whether a significant difference exists in the surgical outcomes following either technique. METHODS: In a prospective study between January and December 2006, 85 children underwent either LS (51) or OS (34) for PIH. Operation time, intra- and postoperative complications, postoperative pain, postoperative stay, cosmesis, and the size of testis were recorded and compared for differences in outcome. Patients were followed up for an average of 3.5 months. RESULTS: All in the open group had unilateral (UL) hernias. The laparoscopy group had 6 (11.8%) bilateral (BL) hernias, and 10 (22.2%) contralateral patencies of processus vaginalis (CPPV) were detected intraoperatively and repaired simultaneously. Bilateral repairs were excluded from comparative analysis. LS was slightly quicker than OS to perform [25.31 min vs 30.65 min (P=0.06)]. The difference in pain perception, between LS and OS, was insignificant. Immediate postoperative recovery was delayed in more children undergoing LS (P=0.02), but the duration of hospital stay was similar (P=0.37). Complication rates were similar (P=0.96). Cosmesis in LS was superior to that in OS. CONCLUSIONS: Well-performed conventional herniotomy yields results similar to those of laparoscopic repair. Cosmesis and the ability to detect and simultaneously repair CPPV are the 2 main advantages of LS over OS. Keeping in mind the low incidence of meta-chronicity in UL hernias, insignificance of cosmesis over the groin, and the constraints of the developing world, conventional open herniotomy can justly be performed for UL hernias, as the standard of care, in centers lacking laparoscopy.
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spelling pubmed-30158822011-02-17 Pediatric Inguinal Hernia: Laparoscopic Versus Open Surgery Saranga Bharathi, Ramanathan Arora, Manu Baskaran, Vasudevan JSLS Scientific Papers BACKGROUND AND OBJECTIVES: Herniotomy/open surgery (OS) has been the time honored treatment for pediatric inguinal hernia (PIH). Laparoscopic surgery (LS) has recently emerged as an alternative in its management. However, controversy is rife on its feasibility and wider adoption. The present need is to know whether a significant difference exists in the surgical outcomes following either technique. METHODS: In a prospective study between January and December 2006, 85 children underwent either LS (51) or OS (34) for PIH. Operation time, intra- and postoperative complications, postoperative pain, postoperative stay, cosmesis, and the size of testis were recorded and compared for differences in outcome. Patients were followed up for an average of 3.5 months. RESULTS: All in the open group had unilateral (UL) hernias. The laparoscopy group had 6 (11.8%) bilateral (BL) hernias, and 10 (22.2%) contralateral patencies of processus vaginalis (CPPV) were detected intraoperatively and repaired simultaneously. Bilateral repairs were excluded from comparative analysis. LS was slightly quicker than OS to perform [25.31 min vs 30.65 min (P=0.06)]. The difference in pain perception, between LS and OS, was insignificant. Immediate postoperative recovery was delayed in more children undergoing LS (P=0.02), but the duration of hospital stay was similar (P=0.37). Complication rates were similar (P=0.96). Cosmesis in LS was superior to that in OS. CONCLUSIONS: Well-performed conventional herniotomy yields results similar to those of laparoscopic repair. Cosmesis and the ability to detect and simultaneously repair CPPV are the 2 main advantages of LS over OS. Keeping in mind the low incidence of meta-chronicity in UL hernias, insignificance of cosmesis over the groin, and the constraints of the developing world, conventional open herniotomy can justly be performed for UL hernias, as the standard of care, in centers lacking laparoscopy. Society of Laparoendoscopic Surgeons 2008 /pmc/articles/PMC3015882/ /pubmed/18765052 Text en © 2008 by JSLS, Journal of the Society of Laparoendoscopic Surgeons This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Saranga Bharathi, Ramanathan
Arora, Manu
Baskaran, Vasudevan
Pediatric Inguinal Hernia: Laparoscopic Versus Open Surgery
title Pediatric Inguinal Hernia: Laparoscopic Versus Open Surgery
title_full Pediatric Inguinal Hernia: Laparoscopic Versus Open Surgery
title_fullStr Pediatric Inguinal Hernia: Laparoscopic Versus Open Surgery
title_full_unstemmed Pediatric Inguinal Hernia: Laparoscopic Versus Open Surgery
title_short Pediatric Inguinal Hernia: Laparoscopic Versus Open Surgery
title_sort pediatric inguinal hernia: laparoscopic versus open surgery
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015882/
https://www.ncbi.nlm.nih.gov/pubmed/18765052
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