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Laparoscopic versus open inguinal hernia repair in children: which is the true gold-standard? A systematic review and meta-analysis.
Kantor, Navot; Travis, Nicole; Wayne, Carolyn; Nasr, Ahmed.
Afiliación
  • Kantor N; Department of Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.
  • Travis N; Faculty of Medicine, University of Ottawa, Ottawa, Canada.
  • Wayne C; Department of Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.
  • Nasr A; Department of Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.
Pediatr Surg Int ; 35(9): 1013-1026, 2019 Sep.
Article en En | MEDLINE | ID: mdl-31292721
PURPOSE: Hernia repair is one of the most common operations performed in children. Traditionally, an open surgical approach has been utilized; however, laparoscopic repair has been gaining favour within the surgical community. We aimed to determine whether open or laparoscopic hernia repair is optimal for pediatric patients by comparing recurrence rates and other outcomes. METHODS: We searched CENTRAL, MEDLINE, and EMBASE from 1980 onwards, including studies that compared laparoscopic and open repair for pediatric inguinal hernia. RESULTS: Our initial search yielded 345 unique citations. Of these, we reviewed the full text of 28, and included 21 in meta-analysis. The results showed that patients who underwent laparoscopic surgery were more likely to experience wound infection (p = 0.003), but less likely to experience ascending testis (p = 0.05) and metachronous hernia (p = 0.0002). There were no differences in recurrence rates (p = 0.95), surgical time (p = 0.55), length of hospitalization (p = 0.50), intra-operative injury, bleeding, testicular atrophy, or hydrocele. CONCLUSION: Laparoscopic and open surgeries are equivalent in terms of recurrence rates, surgical time, and length of hospitalization. Laparoscopic repair is associated with increased risk of wound infection, but decreased risk of ascending testis. Laparoscopic surgery allows the opportunity to explore and repair the contralateral side, preventing metachronous hernia. LEVEL OF EVIDENCE: III.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Laparoscopía / Herniorrafia / Hernia Inguinal Tipo de estudio: Systematic_reviews Límite: Child / Child, preschool / Humans / Male Idioma: En Revista: Pediatr Surg Int Asunto de la revista: PEDIATRIA Año: 2019 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Laparoscopía / Herniorrafia / Hernia Inguinal Tipo de estudio: Systematic_reviews Límite: Child / Child, preschool / Humans / Male Idioma: En Revista: Pediatr Surg Int Asunto de la revista: PEDIATRIA Año: 2019 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Alemania