Highlights
- •Laparoscopic bilateral inguinal hernia repair had higher recurrence in children.
- •Male sex and age < 1-year increase risk for recurrence.
- •Patient factors including age and sex should be considered in approach selection.
- •National recurrence rates differ than those from primarily academic centers.
Abstract
Background
Reported recurrence rates after laparoscopic versus open inguinal hernia repair have
been limited to high volume centers with short follow-up. We sought to compare national
rates of recurrence after laparoscopic versus open bilateral inguinal hernia repair.
Methods
Children under five who underwent bilateral inguinal hernia repair between 2010 and
2020 were identified using the PearlDiver Mariner database. Time to recurrence was
compared using Kaplan Meier analysis and Cox proportional hazards regression models.
Results
Hernia recurrence requiring reoperation occurred in 182 (2.2%) of 8,367 children.
Rate of recurrence was higher following laparoscopic repair compared to open (1-year:
2.8% vs. 1.5%; 3-year: 3.7% vs. 2.0%; p < 0.01). This difference remained after adjustment
for demographic and operative characteristics (adjusted hazard ratio [aHR]: 2.00 [95%
confidence interval [CI]: 1.31, 3.05]).
Conclusions
Risk of recurrence was higher after laparoscopic compared to open repair of bilateral
inguinal hernia repair in a national cohort of children under age five.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: April 18, 2022
Accepted:
April 13,
2022
Received in revised form:
March 25,
2022
Received:
January 27,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
