Laparoscopic simultaneous inguinal hernia repair and appendectomy in children: A multicenter study

Abstract

BackgroundInguinal hernias (IHs) are sometimes encountered incidentally in children during laparoscopic appendectomy. This study aims to evaluate the efficacy and outcomes of laparoscopic simultaneous inguinal hernia repair and appendectomy in children. MethodsA multicentric study was performed in patients with AA and concurrent IH who received laparoscopic simultaneous inguinal hernia repair and appendectomy (study group), compared with patients who underwent two–stage laparoscopic procedures (control group) between September 2012 and January 2020. Intraoperative data, postoperative complications, and clinical outcomes were prospectively collected and retrospectively analyzed. Results189 patients with AA and concurrent IH (117 children in the study group, and 72 children in the control group) were enrolled. No significant differences in preoperative characteristics were identified between the two groups. Patients in the study group had a shorter total operative time and hospital stay than those in the control group (43.2 ± 8.1 vs 53.9 ± 7.3 min, p < 0.001; 1.5 ± 0.8 vs 2.2 ± 0.9 days, p = 0.023). The study group incurred lower costs than the control group (9198.7 ± 587.6 vs 14,392.5 ± 628.6 RMB, p < 0.001). During follow–up (range 1.5–6.0 years), three children in the study group and two children in the control group experienced wound infection. One child in the study group had recurrent IH. ConclusionsLaparoscopic simultaneous procedures do not increase the incidence of wound infection or recurrent IH. Moreover, they avoid repeat anesthesia and hospitalization. Therefore, this approach is safe, feasible and cost-effective for children with AA and concurrent IH. Level of evidenceLevel III.