Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2021; 9(15): 3559-3566
Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3559
Multifactor study of efficacy and recurrence in laparoscopic surgery for inguinal hernia
Wei-Long Chen, Qing-Qiang Deng, Wei Xu, Ming Luo
Wei-Long Chen, Qing-Qiang Deng, Wei Xu, Ming Luo, Department of Pediatric Surgery, Jiangxi Children's Hospital, Nanchang 330003, Jiangxi Province, China
Author contributions: Chen WL designed the study; Deng QQ drafted the work and collected the data; Xu W and Luo M analyzed and interpreted the data and wrote the article.
Institutional review board statement: The study was reviewed and approved by the [Medical Ethics Committee of Children's Hospital of Jiangxi Province] Institutional Review Board, No. JXSETYY-JXS-2019-031.
Informed consent statement: Patients were not required to give informed consent to the study as the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming Luo, MHSc, Attending Doctor, Department of Pediatric Surgery, Jiangxi Children's Hospital, No. 122 Yangming Road, Donghu District, Nanchang 330003, Jiangxi Province, China. luoming113@126.com
Received: December 24, 2020
Peer-review started: December 24, 2020
First decision: January 17, 2021
Revised: January 28, 2021
Accepted: March 5, 2021
Article in press: March 5, 2021
Published online: May 26, 2021
Processing time: 138 Days and 3.1 Hours
Abstract
BACKGROUND

Inguinal hernia is a common clinical manifestation in children with a low self-healing rate.

AIM

To determine the effect of laparoscopic surgery on indirect inguinal hernia and the risk factors for postoperative recurrence and to provide a reference for the clinical treatment and prevention of recurrence.

METHODS

We selected 360 children who underwent laparoscopic high ligation in our hospital as the laparoscopic group and 120 patients treated for inguinal hernia with conventional surgery as the control group. The operation time, blood loss, incision length, hospitalization time, total hospitalization cost and surgical complications were compared between the two groups. According to telephone follow-up or return visits, the children who had recurrence within 2 years after the operation in the laparoscopic group were analyzed, and the laparoscopic high ligation hernia sac level was analyzed by the logistic multifactor method. Ligation was used to treat recurrence in children with inguinal hernia.

RESULTS

The operation time, blood loss, length of incision, and length of hospital stay in the laparoscopic group were lower than those in the control group (P < 0.05). The total hospitalization cost in the laparoscopic group was higher than that in the control group (P < 0.05). The operative complication rate was 1.67% lower than that in the control group (12.50%) (P < 0.05). In 360 children with laparoscopic high ligation of the hernia sac, 14 patients had recurrence within 2 years after surgery. After analysis, 14 cases in the recurrence group did not recur. The preoperative incarceration rate, inner ring diameter, ligature use and age difference were statistically significant (P < 0.05). According to logistic regression multivariate analysis, an inner ring diameter ≥ 1.0 cm, the use of an absorbable ligature line and age > 3 years increased the risk of postoperative recurrence in children with inguinal hernia after laparoscopic high ligation of the hernia sac (P < 0.05).

CONCLUSION

Laparoscopic surgery for indirect inguinal hernia in children has the advantages of low trauma and a rapid postoperative recovery. An inner ring diameter ≥ 1.0 cm, the use of absorbable ligature, and age > 3 years may increase the risk of recurrence after laparoscopic high ligation of the hernia sac.

Keywords: Laparoscopic high ligation of the hernia sac; Pediatric; Inguinal hernia; Recurrence; Risk factors

Core Tip: At present, surgical treatment is the main treatment method for inguinal hernia in children. The traditional open surgical incision is large, and it is very easy to damage the nerves in the inguinal area in children. The high-risk factors that cause recurrence after laparoscopic surgery for inguinal hernia have been analyzed, and early prevention and treatment to improve the prognosis of children has been deemed significantly important. In this study, we analyzed the effect of laparoscopic surgery on indirect inguinal hernia and the risk factors.