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01-03-2017 | Original Article

Laparoscopic versus open inguinal hernia repair in children ≤3: a randomized controlled trial

Authors: Colin D. Gause, Maria G. Sacco Casamassima, Jingyan Yang, Grace Hsiung, Daniel Rhee, Jose H. Salazar, Dominic Papandria, Howard I. Pryor II, Dylan Stewart, Jeffrey Lukish, Paul Colombani, Nicole M. Chandler, Emilie Johnson, Fizan Abdullah

Published in: Pediatric Surgery International | Issue 3/2017

Abstract

Purpose

Laparoscopy is being increasingly applied to pediatric inguinal hernia repair. In younger children, however, open repair remains preferred due to concerns related to anesthesia and technical challenges. We sought to assess outcomes after laparoscopic and open inguinal hernia repair in children less than or equal to 3 years.

Methods

A prospective, single-blind, parallel group randomized controlled trial was conducted at three clinical sites. Children ≤3 years of age with reducible unilateral or bilateral inguinal hernias were randomized to laparoscopic herniorrhaphy (LH) or open herniorrhaphy (OH). The primary outcome was the number of acetaminophen doses. Secondary outcomes included operative time, complications, and parent/caregiver satisfaction scores.

Results

Forty-one patients were randomized to unilateral OH (n = 10), unilateral LH (n = 17), bilateral OH (n = 5) and bilateral LH (n = 9). Acetaminophen doses, LOS, complications, and parent/caregiver scores did not differ among groups. Laparoscopic unilateral hernia repair demonstrated shorter operative time, a consistent finding for overall laparoscopic repair in univariate (p = 0.003) and multivariate (p = 0.010) analysis. No cases of testicular atrophy were documented at 2 (SD = 2.7) years.

Conclusion

Children ≤3 years of age in our cohort safely underwent LH with similar pain scores, complications, and recurrence as OH. Parents and caregivers report high satisfaction with both techniques.

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Title: Laparoscopic versus open inguinal hernia repair in children ≤3: a randomized controlled trial
Authors: Colin D. Gause
Maria G. Sacco Casamassima
Jingyan Yang
Grace Hsiung
Daniel Rhee
Jose H. Salazar
Dominic Papandria
Howard I. Pryor II
Dylan Stewart
Jeffrey Lukish
Paul Colombani
Nicole M. Chandler
Emilie Johnson
Fizan Abdullah
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 3/2017
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-016-4029-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Laparoscopic versus open inguinal hernia repair in children ≤3: a randomized controlled trial

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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