EN
TÜRKÇE
Oral Presentation - 26
PRELIMINARY RESULT LAPAROSCOPIC HERNIA REPAIR
A Alsaggaf, A Ghallab, E Raboe, Y Owiwi, A Zeinelabdeen, M Zidan, M Fayez, A Atta, I Abdelrahem
KFAFH, Jeddah, Saudi Arabia
Background: The open inguinal hernia repair is still considered by pediatric surgeons as the gold standard technique. During the recent years, laparoscopic surgery has emerged as an alternative in the treatment of pediatric inguinal hernia. Different laparoscopic techniques have been used.
Aim: To compare the outcome of laparoscopic hernia repair and open herniotomy.
Patients and methods: Retrospective cohort study conducted in pediatric surgery department at king Fahd Armed Forces Hospital, Jeddah between January and June 2017. Forty six patients underwent either laparoscopic surgery or open surgery for pediatric inguinal hernia repair. Operation time, intra and postoperative complications, cosmetic results, and contralateral patent processus vaginalis (CPPV) were recorded and compared for differences in outcome. Patients were followed up from 6-12 months. The collected data were analyzed using Statistical Package for Social Science (SPSS) version 22, P value < 0.05 was considered significant.
Results: Total 46 patients were operated, 39 (84.8%) were male and 7 (15.2%) were female. Right side inguinal hernias were 18 (39.1%), left were 12 (26.1%), and bilateral sides were 16 (34.8%). 56.5% were less than 1 year, 19.6% were between 1-5 years, and 23.9% were 6-13 years old. Twenty seven patients underwent open herniotomy (OH), 8 underwent laparoscopic percutaneous internal ring suturing PIRS, 11 laparoscopic sac dissection & intracorporeal suturing SDIS. Mean age is 3.61 years, 1.86 years, and 2.56 years for (OR), Lap PIRS and SDIS respectively. For unilateral procedures mean operative time was 36.68 min for OH and 48.80 min for PIRS (P=0.12), and 102.16 min for SDIS (P< 0.001). For bilateral procedures mean operative time was 37.00 min for OH and 63.33 min for PIRS (P=0.12), and 109.00 min for SDIS (P< 0.001). One PIRS was done at time of laparoscopic assisted gastrostomy insertion. Seven (36.8%) CPPV found in laparoscopic surgery. Un-necessary inguinal exploration avoided in one patient. Stitch granuloma developed in one patient underwent SIRS.
Conclusion: There is no significant difference in the operative mean time of Laparoscopic percutaneous internal ring suturing PIRS and open herniotomy (OR). Although the number of cases is small we could conclude that Lap PIRS is safe and efficient with good learning curve and best cosmetic result in the treatment of pediatric inguinal hernia.