OUTCOME OF LAPAROSCOPIC PERCUTANEOUS EXTRA PERITONEAL CLOSURE VERSUS OPEN REPAIR FOR PAEDIATRIC INGUINAL HERNIA. A RANDOMIZED CONTROL TRIAL
DOI:
https://doi.org/10.55519/JAMC-03-10505Keywords:
Inguinal Hernia, Laparoscopic Percutaneous Extra Peritoneal Closure, Open Repair, Contralateral Metachronous Inguinal Hernia.Abstract
Background: Laparoscopic inguinal hernia repair (LIHR) has many benefits like less frequency of metachronous contralateral hernias, minimum complications, comparatively less duration of operation and better cosmetic outcome as compared to the open technique. Objective of the study was to compare the outcome of laparoscopic percutaneous extra-peritoneal closure (LPEC) and open repair for paediatric inguinal hernia in terms of contralateral metachronous hernia, operative time and recurrence. Methods: A randomized controlled trial was conducted at the Department of Paediatric Surgery, Children Hospital Lahore. Non-probability purposive sampling was used, and 296 cases were divided into group-1(managed with conventional open repair) and group-2 (managed with laparoscopic Percutaneous Extra-peritoneal closure). After taking informed consent, data was collected, and cases were studied for operative time, contralateral metachronous hernia and recurrence till 6 months postoperatively. Data analysis was done through SPSS 22.0. Chi-square and independent sample t-test was used for comparison. p-value ≤0.05 was taken as significant. Results: The mean operative time was statistically less in the LPEC group (24.79±3.44 minutes) when compared to the open repair group (28.71±4.54 minutes), p-value <0.001. In the Open repair group, there were 19 (12.8%) cases that had contralateral metachronous hernia, while in the LEPC group, 2 (1.4%) cases had contralateral metachronous hernia p-value <0.001. In the Open repair group, 4(2.7%) cases had a recurrence, while in LPEC group 1 (0.7%) cases had a recurrence, with statistically same recurrence rate, p-value >0.05. Conclusion: The LPEC technique is better than conventional open repair in terms of CMIH, operative time, and recurrence rate.References
Sulaiman J, Sahayam SJ, Senthurpandian S, Anandan H. A study of incidence of different types of groin hernias in adults. Int J Sci Study 2018;5:87–90.
Hamid R, Bhat N. One stitch abdominal closure herniotomy: An alternative to Laparoscopic hernia repair in infants. Curr Pediatr Res 2017;21(1):26–30.
Sharifuzzaman M, Ali MA, Hasina K, Huq MA, Alam MM. A Comparative Study between the Outcome of Laparoscopic Repair and Open Repair of Paediatric Inguinal Hernia. Adv Res Gastroenterol Hepatol 2018;9(5):555772.
Latif MT, Liaqat N, Ahmed E, Dar SM. Is contralateral inguinal exploration justified in a child presenting with unilateral inguinal hernia? Pak J Med Health Sci 2015;9(1):176–8.
Mitra A, Chandak U, Pawaskar Y, Sahu SK, Sinha S, Bansod P, et al. A comparative study between laparoscopic hernia repair and open herniotomy of inguinal hernia in paediatric age group: A prospective randomized controlled study. Am J Surg Res Rev 2021;4(1):24.
Esposito C, St Peter SD, Escolino M, Juang D, Settimi A, Holcomb GW 3rd. Laparoscopic versus open inguinal hernia repair in paediatric patients: a systematic review. J Laparoendosc Adv Surg Tech A 2014;24(11):811–8.
Dreuning K, Maat S, Twisk J, van Heurn E, Derikx J. Laparoscopic versus open paediatric inguinal hernia repair: state-of-the-art comparison and future perspectives from a meta-analysis. Surg Endosc 2019;33(10):3177–91.
Xu C, Xiang B, Jin SG, Luo QC, Zhong L. Transumbilical two-port laparoscopic percutaneous extra-peritoneal closure: a new technique for inguinal hernia repair in children. J Laparoendosc Adv Surg Tech 2013;23(4):392–6.
Yoshimaru K, Kinoshita Y, Shono T. The safety and efficacy of laparoscopic percutaneous extra-peritoneal closure for inguinal hernia in neonates and infants younger than 1 year of age in comparison to older patients. J Laparoendosc Adv Sur Tech A 2017;27(1):91–6.
Miyake H, Fukumoto K, Yamoto M, Nouso H, Kaneshiro M, Nakajima H, et al. Comparison of percutaneous extra-peritoneal closure (LPEC) and open repair for paediatric inguinal hernia: experience of a single institution with over 1000 cases. Surg Endosc 2016;30(4):1466–72.
Ostlie DJ, Ponsky TA. Technical options of the laparoscopic paediatric inguinal hernia repair. J Laparoendosc Adv Surg Tech A 2014;24(3):194–8.
Elekiabi OA, Eraky ME, Abdelhady WA, Sallam AM, Gertallah LM. “A Comparative Study between Laparoscopic Repair and Open Repair of Paediatric Inguinal Hernia; Outcomes and Benefits”. Acta Sci Paediatr 2019;2(6):3–8.
Zenitani M, Saka R, Sasaki T, Takama Y, Tani G, Tanaka N, et al. Safety and efficacy of laparoscopic percutaneous extra-peritoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair. Asian J Endosc Surg 2019;12(4):439–45.
Louati H, Jallouli M, Zouari M, Zitouni H, Ben Dhaou M, Mhiri R. Laparoscopic-Assisted Percutaneous Extraperitoneal Closure for Inguinal Hernia Repair in Children: An Initial Experience. Int J Pediatr 2018;6(8):8039–46.
Acharya H, Agrawal R, Agrawal V, Tiwari A, Chanchlani R. Management of inguinal hernia in children: a single center experience of 490 patients. Int Surg J 2016;3(1):345–8.
Saka R, Okuyama H, Sasaki T, Nose S, Yoneyama C. Safety and efficacy of laparoscopic percutaneous extra-peritoneal closure for inguinal hernias and hydroceles in children: a comparison with traditional open repair. J Laparoendosc Adv Surg Tech A 2014;24(1):55–8.
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