Open versus laparoscopic repair in pediatric incarcerated inguinal hernia: a systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: Statistically significant differences reported for multiple outcomes

• Effect Size: Pooled mean differences and odds ratios calculated (specific values not provided in abstract)

• Primary Outcome: Laparoscopic repair showed significantly shorter operative time, reduced intraoperative blood loss, and shorter hospital stay

• Nnt Or Sensitivity: Lower risk of intraoperative injury and recurrence with laparoscopic approach

• Confidence Interval: 95% confidence intervals calculated

Clinical Application

Requires laparoscopic expertise and equipment availability; may be limited in resource-constrained settings Relevant to Australian pediatric surgery practice; both techniques available in major pediatric centres; MBS items cover both approaches Children presenting with incarcerated inguinal hernia in pediatric surgical units

Abstract

PURPOSE: The optimal surgical approach for pediatric incarcerated inguinal hernia remains controversial. This study aimed to systematically compare the clinical outcomes of laparoscopic repair (LH) and open repair (OH) in children with incarcerated inguinal hernia through a systematic review and meta-analysis. METHODS: A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library from database inception to March 2026. Comparative studies evaluating LH versus OH in pediatric incarcerated inguinal hernia were included. Primary outcomes included operative time, intraoperative blood loss, and length of hospital stay. Secondary outcomes included intraoperative injury, wound infection, testicular atrophy, and recurrence. Pooled mean differences (MD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated using Review Manager 5.4. RESULTS: Nine studies involving 584 pediatric patients were included in the meta-analysis. Compared with OH, LH was associated with significantly shorter operative time and reduced intraoperative blood loss. The length of hospital stay was also significantly shorter in the LH group. In addition, LH showed a significantly lower risk of intraoperative injury and recurrence. No statistically significant differences were observed between the two groups in terms of wound infection or testicular atrophy. CONCLUSIONS: Laparoscopic repair appears to be a safe and effective alternative to open repair for pediatric incarcerated inguinal hernia. Further high-quality prospective studies are warranted to confirm these findings.

References

1. 1.Huang, Huang, Wu, H., Hou, L., & Feng, S. (2026). Open versus laparoscopic repair in pediatric incarcerated inguinal hernia: a systematic review and meta-analysis. Hernia: The Journal of Hernias and Abdominal Wall Surgery. https://doi.org/10.1016/j.jpedsurg.2006.02.028