title: Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis.
abstract: OBJECTIVE
  To undertake a meta-analysis of comparative data of laparoscopic versus open inguinal herniotomy in infants and children.
  
  
  METHODS
  We searched MEDLINE, EMBASE, and The Cochrane Central Controlled Trials Registry for relevant randomized controlled trials and observational studies comparing laparoscopic with open inguinal hernia repair in children aged less than 19 years.
  
  
  RESULTS
  Data on 2,699 children were identified from 10 comparative studies. Laparoscopic techniques were associated with a trend towards higher recurrence rate (OR = 1.81; 95% CI 0.89-3.67; p = 0.10), longer operative time for unilateral repairs (WMD = 10.23; 95% CI 8.82-11.64; p < 0.00001), and may be shorter operative time for bilateral repairs (WMD = -4.54; 95% CI -11.63 to 2.55; p = 0.21). There was a significant reduction in developing a contralateral metachronous inguinal hernia in the laparoscopic group (OR = 0.37; 95% CI 0.20-0.67; p = 0.001).
  
  
  CONCLUSIONS
  Laparoscopic inguinal herniotomy is significantly associated with longer operative time for unilateral cases and a reduction in metachronous hernia development. There was a trend towards higher recurrence rate for laparoscopic repairs and shorter operative time for bilateral cases. A well conducted randomized controlled trial is warranted to compare both approaches.
authors.affiliation: Faculty of Medicine, King Khalid University Hospital, King Saud University, P.O. Box 7805 (37), Riyadh, 11472, Saudi Arabia. aalzahem@ksu.edu
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Alzahem
mesh_terms: D002648:Child; D002675:Child, Preschool; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome