| Autor: |
Derbyshire MC; Department of Surgery, UMass Medical School - Baystate, Springfield, Massachusetts, USA., Grant HM; Department of Surgery, UMass Medical School - Baystate, Springfield, Massachusetts, USA.; Department of Surgery, Institute for Healthcare Delivery and Population Science, UMass Medical School - Baystate, Springfield, Massachusetts, USA., Lam A; Department of Surgery, UMass Medical School - Baystate, Springfield, Massachusetts, USA., Banever GT; Department of Surgery, UMass Medical School - Baystate, Springfield, Massachusetts, USA.; Department of Surgery, Baystate Children's Hospital, Springfield, Massachusetts, USA., Brocks R; Department of Pediatric Surgery and Liver Transplantation, CHU Sainte-Justine, Montreal, Canada., Pepper VK; Department of Surgery, Baystate Children's Hospital, Springfield, Massachusetts, USA., Tashjian DB; Department of Surgery, UMass Medical School - Baystate, Springfield, Massachusetts, USA.; Department of Surgery, Baystate Children's Hospital, Springfield, Massachusetts, USA., Moriarty KP; Department of Surgery, UMass Medical School - Baystate, Springfield, Massachusetts, USA.; Department of Surgery, Baystate Children's Hospital, Springfield, Massachusetts, USA., Tirabassi MV; Department of Surgery, UMass Medical School - Baystate, Springfield, Massachusetts, USA.; Department of Surgery, Baystate Children's Hospital, Springfield, Massachusetts, USA. |
| Abstrakt: |
Introduction: While laparoscopy is now widely accepted for inguinal hernia repair in infants, it traditionally has required general anesthesia. We sought to evaluate the safety of laparoscopic inguinal hernia repair in infants under spinal anesthesia. Materials and Methods: We performed a retrospective cohort study of all inguinal hernia repairs at a single institution between December 2011 and June 2019 in patients younger than 6 months of age. Four groups were compared: laparoscopic under general anesthesia, laparoscopic with spinal anesthesia, open with spinal anesthesia, and open under general anesthesia. Main outcome measures include operative time, cost, and postoperative outcomes. These were assessed using Kruskal-Wallis median comparison. Results: Of the 226 patients meeting inclusion criteria, 54% (122/226) of patients underwent general anesthesia, while 46% (104/226) had spinal. When compared to general anesthesia, spinal anesthesia was associated with significantly shorter procedure times ( P < .01) and lower cost ( P < .01) for both open and laparoscopic approaches. Complications were few and underpowered to calculate significance across each group. Conclusions: Laparoscopic inguinal hernia repair can be safely performed in infants under spinal anesthesia without significant compromise of early perioperative outcomes. Advantages may include shorter procedure time and lower cost. |
