Inguinal hernia repair in inpatient children: a nationwide analysis of German administrative data

Heydweiller, Andreas; Kurz, Ralf; Schröder, Arne; Sochaczewski, Christina Oetzmann von

doi:10.1186/s12893-021-01371-4

Cited by 5 publications

(2 citation statements)

References 41 publications

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“…However, there seems to be a trend towards more prevalent utilization of the laparoscopic technique. In a study of German administrative claims data for the years 2005-2017, laparoscopic IHR was used in boys for between 1% and 3% of cases and in girls for between 2% and 14% of cases for the different age groups [19]. While our analysis showed that the open technique is still used in more than 90% of all patients in 2019, the percentage of laparoscopic IHR increased to 6% of boys and 17% of girls.…”

Section: Discussionmentioning

confidence: 59%

The Status of Laparoscopic Inguinal Hernia Surgery in Children: A Nationwide Assessment

et al. 2022

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Inguinal hernia repair (IHR) is a common procedure in childhood. Laparoscopic IHR has been evolving for the last three decades. Although clear advantages have been shown, adaptation in Germany has been slow. We aim to study the current status of pediatric laparoscopic IHR. A survey was sent to all 89 pediatric surgical departments in Germany on current practices and preferences of open versus laparoscopic IHR. Two nationwide databases of administrative claims data from 2019 were analyzed and correlated with responses from the survey. A total of 56% of the pediatric surgical departments supplied data through the quality reports. The recall of our survey was 58% of all pediatric surgery departments. According to the pooled data, laparoscopic IHR was performed in 8.2% of all inpatients treated. Laparoscopic IHR was considered a training procedure in 48% of the departments. Five different laparoscopic techniques were described (most commonly percutaneous closure of the hernia under laparoscopic vision). The choice between open and laparoscopic IHR was mainly determined by the child’s age. Currently, only a minority of German children undergo inguinal hernia repair by laparoscopy. More training opportunities in the form of hands-on and video workshops may lead to more widespread employment of the laparoscopic technique.

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Section: Discussionmentioning

confidence: 59%

The Status of Laparoscopic Inguinal Hernia Surgery in Children: A Nationwide Assessment

et al. 2022

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“…Statistical analyses were conducted using R (RRID: SCR_001905) (version 3.5.3) with its generic stats4 package [9], if not stated otherwise. Changes over time were analysed by ordinary least squares linear regression [10][11][12][13], whose requirements of normality of residuals were checked by using the Kolmogorov-Smirnov test and the presence of homoscedasticity was verified by the Breusch-Pagan test, both from the olsrr package (version 0.5.3) [14], aided by visual analysis of QQ plots [15].…”

Section: Open Accessmentioning

confidence: 99%

The epidemiology of funnel chest repairs in Germany: monitoring the success of Nuss’ procedure

Heydweiller

Sochaczewski

2022

Cardiothorac Surg

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Background In recent years, the Nuss procedure was gaining ground in pectus excavatum repair, but the scientific focus had been on complications compared to conventional repairs. Despite a substantial prevalence of pectus excavatum in population-based studies, the adoption of minimally invasive funnel chest repair and subsequent replacement of conventional procedures has not been assessed on a population-based level. Methods We analysed German administrative case-based data on funnel chest repairs separate by age group and operative procedure: conventional or minimally invasive. Changes over time between 2010 and 2018 were analysed by linear regression. Results There were x̅ = 256 operations per year, which did not change throughout the study time, but following the introduction of minimally invasive repairs, their usage increased particularly in males aged 15 to 19 years by 8.7 procedures per year (P = 0.0142) and was accompanied by a concomitant decrease in conventional repairs in all relevant age groups. We observed a shift of operations towards the age group of 15 to 19 years, whose numbers increased by 5.3 yearly procedures (P = 0.0222), whereas they decreased in all other relevant age groups. These shifts could not be observed in females in a similar fashion, but in both males and females, the numbers of minimally invasive per conventional repair increased. Conclusions In Germany, the introduction of the Nuss procedure did result in a concentration of funnel chest repairs in adolescence and a replacement of conventional repairs. Data from other healthcare systems are missing but are direly needed to assess the current situation in other healthcare systems. Level of evidence III.

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Comparison of long-term outcomes of laparoscopic percutaneous internal ring suturing and classic open approach for inguinal hernia repair in children

Kılıç

2024

annals

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Introduction Inguinal hernia repair is one of the most common surgeries in children. Recently, the use of minimally invasive techniques for inguinal hernia repair has increased in children. Laparoscopic percutaneous internal ring suturing (PIRS) is a technique described for paediatric inguinal hernia repair. The primary objective of this study is to demonstrate the efficacy and reliability of PIRS in paediatric patients through a comparative analysis with an open method. Methods Between January 2017 and June 2023, records of patients who underwent surgery for inguinal hernia were retrospectively reviewed. In total 126 patients were included in the study. They were divided into two groups: 33 patients underwent PIRS (group 1) and 93 patients underwent open repair (group 2). Operation time, cost and complications were compared. Results The mean age of the 126 patients was 3.23 ± 2.4 years. The mean unilateral operative time was 25.13 ± 5.32min in group 1 and 30.28 ± 4.73min in group 2, and there was a statistically significant difference in operative time (p < 0.001). Two patients in group 1 underwent surgery owing to patent processus vaginalis, whereas three patients in group 2 underwent surgery owing to metachronous hernia. There were no major complications such as bleeding requiring surgical intervention or conversion to an open approach during surgery in group 1. No recurrent hernia was observed in any of the 126 patients. Conclusions PIRS offers a safe, easy-to-learn method with low complication rates. PIRS has a distinct advantage over open surgical repair because of its capacity to evaluate the contralateral inguinal ring.

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Inguinal hernia repair in inpatient children: a nationwide analysis of German administrative data

Cited by 5 publications

References 41 publications

The Status of Laparoscopic Inguinal Hernia Surgery in Children: A Nationwide Assessment

The Status of Laparoscopic Inguinal Hernia Surgery in Children: A Nationwide Assessment

The epidemiology of funnel chest repairs in Germany: monitoring the success of Nuss’ procedure

Comparison of long-term outcomes of laparoscopic percutaneous internal ring suturing and classic open approach for inguinal hernia repair in children

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