Open versus minilaparoscopic herniorrhaphy for children: a prospective comparative trial with midterm follow-up evaluation.

摘要

BACKGROUND: A prospective clinical trial was designed to compare the midterm surgical and functional results between open (OR) and minilaparoscopic (MR) herniorrhaphy repairs for pediatric inguinal hernia. METHODS: Between May 2005 and May 2008, 174 children with inguinal hernias were prospectively enrolled for either open or minilaparoscopic hernia repair. Of these children, 65 underwent open herniorrhaphy and 109 underwent minilaparoscopic herniorrhaphy. The postoperative functional status, pain, complications, and overall satisfaction were documented at outpatient clinic visits for analysis. RESULTS: During the study period, 35 patients were lost to follow-up evaluation and thus excluded. The mean follow-up period was about 2 years, and the baseline characteristics were matched between the two groups. The patients in the MR group had recurrence rates, postoperative pain, complications, and functional recovery comparable with those in the OR group. None in the MR patients experienced a contralateral metachronous inguinal hernia compared with 9.7% of the OR patients (p = 0.02). The MR patients had a higher rate of overall satisfaction than the OR patients (p = 0.03). CONCLUSIONS: Minilaparoscopic herniorrhaphy was superior to open repair with regard to prevention of contralateral hernia occurrence and overall satisfaction.