Comparative Evaluation of Laparoscopic vs. Open Inguinal Herniotomy in Infants
AbstractObjective: To evaluate outcomes after open and laparoscopic herniotomy, and analyze potential risk factors that led to recurrence. Background: Is laparoscopic inguinal hernia repair a safe and effective alternative procedure in children? Methods: One hundred and ninety-five consecutive infants underwent an open herniotomy (group 1), and 44 infants underwent laparoscopic herniotomy (group 2) between January 1994 to July 2002. The end-point was successful herniotomy without recurrence. Results: The mean period of follow-up for group 1 was 37 months vs . 7 months for group 2. The incidence of synchronous bilateral hernia in group 1 was 24% vs . 31% in group 2 (p = 0.453) and of bilateral metachronous hernia was 17% vs . 21% in group 2 ( p = 0.232). Hernia recurred in 3 cases in group 1 (1%) vs . 4 cases (5.7%) in group 2. Regression analysis showed that the potential risk factors that increased the incidence of recurrence in group 2 were: prematurity (<32 weeks of gestational age) ( p = 0.0001); intra-uterine growth retardation ( p = 0.0001); chronic lung disease ( p = 0.0001); and stadium configuration of the internal ring ( p = 0.0001). There were no identifiable risk factors in group 1. Conclusion: Laparoscopic herniotomy is a viable option for the management of infantile inguinal hernias.