Treffer: Comparison of laparoscopic percutaneous extraperitoneal closure (LPEC) and open herniotomy (OH) in pediatric inguinal hernia: a retrospective cohort study on operative time and complications.
Nakashima M, Ide K, Kawakami K (2019) Laparoscopic versus open repair for inguinal hernia in children: a retrospective cohort study. Surg Today 49:1044–1050. https://doi.org/10.1007/s00595-019-01847-0. (PMID: 10.1007/s00595-019-01847-031312986)
Zenitani M, Saka R, Sasaki T, Takama Y, Tani G, Tanaka N, Ueno T, Tazuke Y, Oue T, Okuyama H (2019) Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: a comparison with conventional open repair. Asian J Endosc Surg 12:439–445. https://doi.org/10.1111/ases.12676. (PMID: 10.1111/ases.1267630561153)
Muensterer OJ, Gianicolo E (2019) Contralateral processus closure to prevent metachronous inguinal hernia: a systematic review. Int J Surg 68:11–19. https://doi.org/10.1016/j.ijsu.2019.06.001. (PMID: 10.1016/j.ijsu.2019.06.00131185313)
Yoshimura S, Hattori K, Tsuji E, Tsugawa J, Nishijima E (2024) Prolonged umbilical port insertion time increases the incidence of umbilical surgical site infection in laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children. J Laparoendosc Adv Surg Tech A lap.2024.0172. https://doi.org/10.1089/lap.2024.0172. (PMID: 10.1089/lap.2024.0172)
Lam CS, Dhedli PK, Russell S, Stedman FE, Hall NJ (2022) Cost-effectiveness of laparoscopic and open pediatric inguinal hernia repair. J Laparoendosc Adv Surg Tech 32:805–810. https://doi.org/10.1089/lap.2021.0800. (PMID: 10.1089/lap.2021.0800)
Suttiwongsing A, Khorana J, Ruangwongroj P, Niruttiwat K (2022) Laparoscopic extraperitoneal technique versus open inguinal herniotomy in children: historical controlled intervention study. World J. Pediatr. Surg. 5:e000436. https://doi.org/10.1136/wjps-2022-000436. (PMID: 10.1136/wjps-2022-000436364747459716936)
Cóbar JP, Nichol PF (2023) Introduction of pediatric laparoscopic inguinal hernia repair in Guatemala. BMC Surg 23:361. https://doi.org/10.1186/s12893-023-02262-6. (PMID: 10.1186/s12893-023-02262-63801260310683215)
Lee C-H, Chen Y, Cheng C-F, Yao C-L, Wu J-C, Yin W-Y, Chen J-H (2016) Incidence of and risk factors for pediatric metachronous contralateral inguinal hernia: analysis of a 17-year nationwide database in Taiwan. PLoS One 11:e0163278. https://doi.org/10.1371/journal.pone.0163278. (PMID: 10.1371/journal.pone.0163278276847105042430)
Yoshizawa J, Ashizuka S, Kuwashima N, Kurobe M, Tanaka K, Ohashi S, Hiramatsu T, Baba Y, Kanamori D, Kaji S, Ohki T (2013) Laparoscopic percutaneous extraperitoneal closure for inguinal hernia: learning curve for attending surgeons and residents. Pediatr Surg Int 29:1281–1285. https://doi.org/10.1007/s00383-013-3337-1. (PMID: 10.1007/s00383-013-3337-123864277)
Zhu L, Chen X, Xu W, Liu J, Huang X, Xiong J, Lv Z (2022) The relationship between contralateral patent processus vaginalis and metachronous contralateral inguinal hernia in children with unilateral inguinal hernia: a prospective observational study. Hernia 26:1161–1168. https://doi.org/10.1007/s10029-022-02638-2. (PMID: 10.1007/s10029-022-02638-235821302)
Yang C-J, Cheng P-L, Huang Y-J, Huang F-H (2024) Laryngeal mask airway as an appropriate option in pediatric laparoscopic inguinal hernia repair: a systematic review and meta-analysis. J Pediatr Surg 59:660–666. https://doi.org/10.1016/j.jpedsurg.2023.11.024. (PMID: 10.1016/j.jpedsurg.2023.11.02438171956)
Maskal S, Ellis R, Prabhu A, Miller B, Beffa L, Krpata D, Rosen M, Petro C (2023) Injuries incurred from minimally invasive access for abdominal surgery. Surg Endosc 37:5368–5373. https://doi.org/10.1007/s00464-023-10031-y. (PMID: 10.1007/s00464-023-10031-y36997650)
Duess JW, Schaller M-C, Lacher M, Sorge I, Puri P, Gosemann J-H (2020) Accidental bladder injury during elective inguinal hernia repair: a preventable complication with high morbidity. Pediatr Surg Int 36:235–239. https://doi.org/10.1007/s00383-019-04554-6. (PMID: 10.1007/s00383-019-04554-631602498)
Wenk K, Sick B, Sasse T, Moehrlen U, Meuli M, Vuille-dit-Bille RN (2015) Incidence of metachronous contralateral inguinal hernias in children following unilateral repair - a meta-analysis of prospective studies. J Pediatr Surg 50:2147–2154. https://doi.org/10.1016/j.jpedsurg.2015.08.056. (PMID: 10.1016/j.jpedsurg.2015.08.05626455468)
Weitere Informationen
Background: Laparoscopic surgery is widely used for pediatric inguinal hernia repair, but evidence from resource-limited settings remains scarce. This study compared outcomes of open herniotomy (OH) and laparoscopic percutaneous extraperitoneal closure (LPEC) in a regional Thai hospital.
Methods: We conducted a retrospective review of children who underwent OH or LPEC between January 2018 and January 2024. A one-to-one propensity score-matched cohort was created based on age and sex. Outcomes included operative time, anesthetic time, and complications. Univariable and multivariable linear regression identified factors influencing operative and anesthetic time.
Results: Among 358 operations, 118 matched pairs (236 patients) were analyzed. Median operative time was longer for unilateral LPEC (30 vs. 25 min, p < 0.001) but shorter for bilateral cases (35 vs. 45 min, p = 0.027). Anesthetic time was longer in unilateral LPEC (70 vs. 55 min, p < 0.001) with no difference for bilateral repairs. Multivariable analysis showed LPEC added 4.3 min (95% CI: 0.8-7.9) to operative time after adjusting for confounders. Complication (OH 15.0% vs. LPEC 13.5%) and recurrence rates (1.2% vs. 1.1%) were similar. Metachronous contralateral inguinal hernia (MCIH) occurred only in OH (13.4%), whereas CPPV was detected in 38.6% of unilateral LPEC cases (NNT = 9).
Conclusion: LPEC is safe, prevents MCIH, and should be considered a first-line option when available.
(© 2026. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Declarations. Conflict of interest: The authors declare no conflict of interest. Declaration of generative AI and AI-assisted technologies in the writing process: During the preparation of this work, the author(s) used ChatGPT and Grammarly to improve language and readability. After using this service, the authors reviewed and edited the content as needed and took full responsibility for the content of the publication.