Abstract
BackgroundCongenital primary inguinal hernia is a common condition among children. Although much literature regarding inguinal hernia is available, large scale analysis are few, and rarely do they expand on gender difference or incarcerated hernias.MethodsPatients with unilateral or bilateral inguinal hernia who were admitted to our hospital and received open inguinal hernia repair (OIHR) or laparoscopic inguinal hernia repair (LIHR) under general anesthesia were included. LIHR was performed using single-site laparoscopic percutaneous extraperitoneal closure (SLPEC). Medical records were retrospectively collected and analyzed.ResultsA total of 12,190 patients were included in this study. The ratio of male to female was 4.8:1. There was a total of 10,646 unilateral hernias (87.3%) and 1544 bilateral hernias (12.7%), with a corresponding ratio of 6.9:1. 12,444 hernia repair surgeries, 11,083 (89.1%) OIHR and 1361 (10.9%) LIHR, were held. OIHR had a shorter operative time than LIHR for all unilateral and female bilateral repair, unlike for bilateral male repair. There was no difference between OIHR and LIHR for ipsilateral recurrent hernia in males. There was a difference between OIHR and LIHR for metachronous contralateral hernia. Incarcerated inguinal hernia was associated with longer operative time, hospital stay and higher hospital costs. Females and patients under 1 year were more likely to present with incarcerated hernia.ConclusionsOIHR should be considered for male patients, especially for unilateral and complete inguinal hernia. LIHR is highly recommended for female patients. For incarcerated hernia, attention should be paid to patients under 1 year old, as they can be 60 times more susceptible, and females. Surgeons should also be aware of ovary hernias in females.
Highlights
Congenital primary inguinal hernia is a common condition among children
Our goal was to describe the different characteristics of pediatric inguinal hernia in a large population for both genders based on our 12-year experience, and to recommend one of the two commonly used methods of hernia repair: the traditional open inguinal hernia repair (OIHR) and laparoscopic inguinal hernia repair (LIHR), conducted by single-site laparoscopic percutaneous extraperitoneal closure (SLPEC) [8]
Reviewing our 12-year experience of 12,190 patients between 2007 to 2019, we have summarized the characteristics and treatment results for pediatric ordinary and incarcerated inguinal hernia based on gender, and provide our recommendations
Summary
Congenital primary inguinal hernia is a common condition among children. much literature regarding inguinal hernia is available, large scale analysis are few, and rarely do they expand on gender difference or incarcerated hernias. Congenital primary inguinal hernia is a common condition among children and with an estimated 20 million cases worldwide each year, hernia repair is postured to be the most frequent surgical procedure within the pediatric population [1, 2]. Our goal was to describe the different characteristics of pediatric inguinal hernia in a large population for both genders based on our 12-year experience, and to recommend one of the two commonly used methods of hernia repair: the traditional open inguinal hernia repair (OIHR) and laparoscopic inguinal hernia repair (LIHR), conducted by single-site laparoscopic percutaneous extraperitoneal closure (SLPEC) [8]. A double suture hernia needle was inserted at the surface projection of the internal inguinal ring, and the peritoneum was punctured after threading a half circle around the hernia sac. Contralateral exploration was performed and all contralateral patent processus vaginalis (PPV) were repaired simultaneously for the potential contralateral synchronous hernia (CSH) during LIHR
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