A Retrospective Nationwide Comparison of Laparoscopic vs Open Inguinal Hernia Repair in Children.
Document Type
Article
Publication Date
2-2025
Identifier
DOI: 10.1016/j.jpedsurg.2024.162056
Abstract
BACKGROUND: Utilization of the laparoscopic approach for inguinal hernia repair has increased significantly over the past decade. The purpose of this study is to compare rates of second hernia operation and same side recurrence following open and laparoscopic inguinal hernia repair in a large national cohort.
METHODS: This retrospective analysis utilized the Pediatric Health Information System database to identify childrenrates, inclusive of same side recurrence and metachronous contralateral hernia, and same side recurrence rates were compared by multivariable mixed effects model controlling for confounders and institutional clustering. Misclassification rates were determined through data validation at four constituent institutions. Sensitivity analyses determined true outcome rates.
RESULTS: We identified 53,287 operations (15.6% laparoscopic). Rate of second hernia operation was greater following laparoscopic repair (2.9% vs 2.6%, p = 0.04) with no difference on multivariable analysis (OR 1.14, 95% CI 0.98-1.32). Same side recurrence rate was greater following laparoscopic repair (1.5% vs 0.4%, p < 0.001) which persisted on multivariable analysis (OR 3.72, 95% CI 2.90-4.78). Sensitivity analysis demonstrated true laparoscopic and open repair rates of 14.2% and 85.8%, respectively. True rates of second hernia operation and same side recurrence were identical to those determined by PHIS.
CONCLUSION: Laparoscopic inguinal hernia repair in children has more than three times the odds of same side hernia recurrence than open repair which is balanced by a reduced rate of second operation for metachronous hernia.
LEVEL OF EVIDENCE: Treatment Study - Level III.
Journal Title
Journal of pediatric surgery
Volume
60
Issue
2
First Page
162056
Last Page
162056
MeSH Keywords
Humans; Hernia, Inguinal; Laparoscopy; Retrospective Studies; Herniorrhaphy; Child; Female; Male; Child, Preschool; Recurrence; Infant; Adolescent; Reoperation; United States
PubMed ID
39541929
Keywords
Children; Hernia repair; Inguinal hernia; Laparoscopic surgery; Minimally invasive surgical procedures; Pediatrics
Recommended Citation
Carter M, Papastefan ST, Tian Y, et al. A Retrospective Nationwide Comparison of Laparoscopic vs Open Inguinal Hernia Repair in Children. J Pediatr Surg. 2025;60(2):162056. doi:10.1016/j.jpedsurg.2024.162056
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