Multifactor study of efficacy and recurrence in laparoscopic surgery for inguinal hernia

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.

Average Long-Term Outcomes of Laparoscopic Inguinal Hernia Repair

“…Meanwhile, the ratio of the late postoperative complications rate after hernioplasty, primarily relapses, does not appear to have been finally resolved [17,18]. One of the key aspects in the relapse prevention is the possibility of suturing an overly expanded internal ring, which is the problem of our study.…”