Comparison of percutaneous extraperitoneal closure (LPEC) and open repair for pediatric inguinal hernia: experience of a single institution with over 1000 cases

Miyake, Hideaki; Fukumoto, Koji; Yamoto, Masaya; Nouso, Hiroshi; Kaneshiro, Masakatsu; Nakajima, Hideaki; Koyama, Mariko; Urushihara, Naoto

doi:10.1007/s00464-015-4354-z

Cited by 53 publications

(68 citation statements)

References 34 publications

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“…One reported advantage of LPEC is the prevention of MCH because the contralateral PPV can be closed simultaneously . In the present study, 60% of patients with a clinically unilateral inguinal hernia had a contralateral PPV.…”

Section: Discussionsupporting

confidence: 48%

“…Additionally, LPEC is useful in incarcerated hernia cases because inspection of the hernia contents after reduction can be easily performed by laparoscopic observation. One reported advantage of LPEC is the prevention of MCH because the contralateral PPV can be closed simultaneously (2,4,5,14). In the present study, 60% of patients with a clinically unilateral inguinal hernia had a contralateral PPV.…”

Section: Discussionsupporting

confidence: 46%

“…Recently, LPEC has been reported to have several advantages over OR, including prevention of MCH and a shorter operative time (1)(2)(3)(4)(5). Therefore, LPEC has been widely used for pediatric inguinal hernia repair in Japan, regardless of the patient's age and sex.…”

Section: Discussionmentioning

confidence: 99%

“…Open repair (OR) has been the gold standard treatment for indirect inguinal hernia in children for a long time. Recently, there have been several reports regarding the safety and efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC), which is a laparoscopic extraperitoneal herniorrhaphy developed by Takehara et al in 1996 . However, to our knowledge, there have been no reports of LPEC limited to infants younger than 6 months.…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair

Zenitani

Saka

Sasaki

et al. 2018

Asian J Endoscop Surgery

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Introduction This study aimed to compare the safety and efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC) and conventional open repair (OR) for inguinal hernia in infants younger than 6 months. Methods The medical records of 202 patients who had undergone LPEC or OR at an age younger than 6 months between 2010 and 2016 were reviewed. Patient characteristics and surgical outcomes were compared between LPEC and OR. Results In total, there were 120 LPEC (76 males, 44 females) and 83 OR (76 males, 7 females) cases. There were no differences in median age, median bodyweight, and presence of incarceration between the two groups (LPEC group: 3 months (range, 0–5 months), 5.7 kg (range, 2.3–9.6 kg), and 13.3%; OR group: 3 months (range, 1–5 months), 5.5 kg (range, 2.1–9.0 kg), and 12.0%). LPEC was completed in all cases without any intraoperative complications or open conversions. In the LPEC group, 60.0% of unilateral hernia patients had a contralateral patent processus vaginalis and underwent prophylactic closure. The incidence of metachronous contralateral hernia was significantly lower in the LPEC group than in the OR group (0% vs 10.0%, P < 0.01). Operative time was significantly shorter during LPEC than during OR (P < 0.01) for male patients. The recurrence rate was lower in the LPEC group (0.83%) than in the OR group (2.4%), but the difference was not significant. Conclusion The present data indicate that LPEC is comparable to OR in terms of safety and efficacy in infants younger than 6 months. Moreover, among the LPEC group, there were fewer incidences of metachronous contralateral hernia, and the procedure had a shorter operative time.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair

Zenitani

Saka

Sasaki

et al. 2018

Asian J Endoscop Surgery

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“…Traditionally, open surgery has been performed for IH; however, laparoscopy is currently being explored [2] as a treatment option [2][3][4][5]. Laparoscopic percutaneous extraperitoneal closure (LPEC) was rst reported in 1995, and has gained popularity as being the standard treatment procedure for IH [6][7][8][9]. Its bene ts are: 1) con rming the contralateral patent processus vaginalis (CPPV), indicating contralateral side recurrence in the future, and 2) the cosmetic result of the process.…”

Section: Introductionmentioning

confidence: 99%

The meaning of laparoscopic procedure against inguinal hernia

Satō

Yoshizawa

Sugiyama

et al. 2020

Preprint

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Background Laparoscopic approach, especially laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia (IH) is widely spread but few studies have compared its invasiveness with that of conventional approach (POTTS). This study compared the role and invasiveness of LPEC with POTTS at our institute. Material and methods The records of 940 IH patients from 2014 to 2019 were analyzed on the basis of age, sex, method of surgery, pre- and post-operative diagnosis, postoperative symptoms, and complications. Results The POTTS group comprised 393 males, of which 44 were diagnosed with contralateral hernia (7.1%). In the LPEC group, 158 males had an average age of 3.88 years. The contralateral patent processus vaginalis (CPPV) was identified in 148 patients during operation. POTTS operation time for patients aged < 1 year was 42.7 minutes, vs 33.4 minutes for LPEC. The two groups experienced comparable paces of fever and first oral intake time; however, pain and recurrence rate were greater in the LPEC group. Conclusion LPEC can be performed to avoid contralateral recurrences; surgical time is reduced for patients aged < 1 year. However, the reduced invasiveness of LPEC compared to that of POTTS did not minimize postoperative symptoms or complications.

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The outcome of closure of inguinal hernia with laparoscopic percutaneous extraperitoneal closure in young adults

Tanaka,

Miyaki,

Abe

et al. 2023

World j. surg.

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BackgroundHernioplasty is one of the most commonly performed surgeries. However, the optimal procedure for young adults has not been defined yet. Our study compared the outcomes of laparoscopic percutaneous extraperitoneal closure (LPEC) in young adults with outcomes in children.Material and MethodsWe retrospectively reviewed patients aged 0–30 years who underwent LPEC. Data regarding age, sex, hernia type, surgical time, pre‐intraoperative laterality, contralateral patent processus vaginalis (CPPV), and complications were analyzed.ResultsLPEC was performed on 2642 patients in our hospital. Of these, 51 patients were young adults (aged 15–30 years). Asymptomatic CPPV in unilateral patients was frequent in the <15‐year age group (50.2%) compared to the 15–30‐year age group (15.9%). The median surgical time was shorter in the <15‐year age group (19 min, interquartile range [IQR]: 24–33) compared to that of the 15–30‐year age group (33 min, IQR: 23.3–40.8).ConclusionsThis is the first report on the outcomes in young adult patients who underwent LPEC. The median surgical time was longer in the 15–30‐year age group than in the <15‐year age group. The median follow‐up was 4.7 years with no intra‐postoperative complications, such as postoperative bleeding, infection, persistent pain, and recurrence. LPEC is an effective, cosmetic, and safe surgical treatment in young adults and children.

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Comparison of percutaneous extraperitoneal closure (LPEC) and open repair for pediatric inguinal hernia: experience of a single institution with over 1000 cases

Abstract: Both OR and LPEC obtained satisfactory results from the perspective of recurrence rate and complications. Prophylactic contralateral LPEC is useful for preventing CMIH without prolonging operative time compared with OR. The midterm safety and efficacy of LPEC are proven.

Cited by 53 publications

References 34 publications

Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair

Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair

The meaning of laparoscopic procedure against inguinal hernia

The outcome of closure of inguinal hernia with laparoscopic percutaneous extraperitoneal closure in young adults

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