Laparoscopy is increasingly used for pediatric inguinal hernia repair.

Autor: Shaughnessy MP; Department of Surgery, Division of Pediatric Surgery at Yale University, 333 Cedar St, FMB 131, New Haven, CT, United States., Maassel NL; Department of Surgery, Division of Pediatric Surgery at Yale University, 333 Cedar St, FMB 131, New Haven, CT, United States., Yung N; Department of Surgery, Division of Pediatric Surgery at Yale University, 333 Cedar St, FMB 131, New Haven, CT, United States., Solomon DG; Department of Surgery, Division of Pediatric Surgery at Yale University, 333 Cedar St, FMB 131, New Haven, CT, United States., Cowles RA; Department of Surgery, Division of Pediatric Surgery at Yale University, 333 Cedar St, FMB 131, New Haven, CT, United States. Electronic address: robert.cowles@yale.edu.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2021 Nov; Vol. 56 (11), pp. 2016-2021. Date of Electronic Publication: 2021 Jan 27.
DOI: 10.1016/j.jpedsurg.2021.01.032
Abstrakt: Introduction: Inguinal hernia repairs (IHR) are commonly performed by pediatric surgeons in the United States. The operative approach depends on surgeon preference with no definitive prospective studies comparing laparoscopic inguinal hernia repair (LIHR) versus traditional inguinal hernia repair (TIHR). We aim to assess current practice, hypothesizing that laparoscopy is increasingly used for pediatric IHR.
Material & Methods: The Children's Hospital Association (CHA) Pediatric Health Information System was queried for IHRs performed between 01/01/2009 and 12/31/2018. Demographics, procedure type, hernia laterality, and cost were obtained. Patients were grouped by procedure type (laparoscopic/traditional).
Results: 125,249 IHRs were performed at 32 CHA hospitals during the ten-year study period. 115,782 (92.4%) were TIHR and 9467 (7.6%) LIHR. Use of laparoscopy increased 5-fold from 3% to 15% over the study period. When comparing laparoscopic to traditional IHR groups, there were more females (28.3% vs 12.6%), African-Americans (19.7% vs 14.4%), government-insured (50% vs 45.2%), younger patients (4.2 vs 4.4 years), bilateral IHRs (11.4% vs 7.9%), and higher adjusted total hospital cost ($3,791 vs $2995) in the laparoscopic group (p<0.0001, all comparisons).
Conclusions: Laparoscopy for pediatric IHR is increasing at CHA hospitals where nearly 1 in 6 children currently undergoes a laparoscopic repair. The long-term outcomes with laparoscopic repair are worthy of future study.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
Externí odkaz: