title: Towards a near-zero recurrence rate in laparoscopic inguinal hernia repair for pediatric patients.
abstract: OBJECTIVE
  The aim of this study was to assess whether the median or lateral umbilicus ligament covering the internal hernia opening region after the purse-string knot could eliminate recurrence in laparoscopic inguinal hernia repair in pediatric patients of all ages.
  
  
  METHODS
  About 482 laparoscopic inguinal hernia repairs in 428 children of various ages were prospectively study in our institution from January 2000 to January 2004. The patients were divided into two groups randomly. In group A, the patients were accepted laparoscopic purse-string knot closing the internal hernia opening only; in group B, the patients were accepted the median or lateral umbilicus ligament covering the internal hernia opening region after the laparoscopic purse-string knot. The data from both groups of operations were then compared.
  
  
  RESULTS
  A total of 239 hernias were repaired in group A (214 patients), whereas 243 in group B (214 patients). The differences between the sex ratio of boys to girls (199:15 versus 197:17) and the mean ages (51.05 ± 49.65 versus 50.59 ± 48.87 months) in the two groups were not statistically significant. The recurrence rate in group B was lower than that in group A and was statistically significant (0.00% versus 4.18%, P < .05). There were no postoperative testicular atrophy in either group of the patients.
  
  
  CONCLUSIONS
  It is possible to achieve a near-zero recurrence rate in laparoscopic hernia repair in pediatric patients of all ages, especially for the patients with large hernia sac (diameter >1.5 cm) and the age over 5 years.
authors.affiliation: Department of General Surgery, The Second People's Hospital of Guangdong Province, Guangzhou, China.
authors.forename: Kaiyun
authors.initials: K
authors.lastname: Chen
authors.forename: Guoan
authors.initials: G
authors.lastname: Xiang
authors.forename: Hanning
authors.initials: H
authors.lastname: Wang
authors.forename: Fanglian
authors.initials: F
authors.lastname: Xiao
mesh_terms: D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008022:Ligaments; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D013514:Surgical Procedures, Operative / Q000379:methods