title: Comparative mid-term results between inguinal herniotomy and single-port laparoscopic herniorrhaphy for pediatric inguinal hernia.
abstract: BACKGROUND
  Some recent papers have advocated single-port laparoscopic herniorrhaphy and obtained satisfactory results. The aim of this study was to compare the mid-term outcomes of conventional inguinal herniotomy and single-port laparoscopic herniorrhaphy.
  
  
  METHODS
  Between April 2007 and March 2009, 202 records of infants and children with inguinal hernia treated were retrospectively reviewed. Of them, 86 patients were treated by conventional inguinal herniotomy (IH group), and 116 patients by single-port laparoscopic herniorrhaphy with preperitoneal hydrodissection, a totally extraperitoneal enclosing suture and extracorporeal knot tying (LH group). Follow-up data were collected using a telephone questionnaire and last outpatient follow-up.
  
  
  RESULTS
  Mean follow-up was 35.7±7.2 months. Both procedures could achieve compete repair without recurrence. Operation time of unilateral repair was significantly longer in the LH group than in the IH group (40.1 vs. 20.0 min; P<0.001); however, operation time of bilateral repairs was comparable in both groups (46.0 vs. 37.5 min; P=0.291). Metachronous hernia developed in 6 of 80 patients (7.5%) initially presenting with unilateral hernia in the IH group and in no patient in the LH group (P=0.005).
  
  
  CONCLUSIONS
  Accompanied by the method of preperitoneal hydrodissection and a totally extraperitoneal enclosing suture, single-port laparoscopic herniorrhaphy would be an effective procedure as conventional inguinal herniotomy. Single-port laparoscopic herniorrhaphy was associated with long operation time and a reduction in contralateral hernia development. However, every 4 patent processus vaginalis would require intervention to prevent 1 metachronous hernia.
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung 80708, Taiwan. 890300@ms.kmuh.org.tw
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Chang
authors.forename: Jao-Yo
authors.initials: JY
authors.lastname: Lin
authors.forename: Jui-Ying
authors.initials: JY
authors.lastname: Lee
authors.forename: Cheng-Jing
authors.initials: CJ
authors.lastname: Tsai
authors.forename: Wen-Chun
authors.initials: WC
authors.lastname: Chiu
authors.forename: Chi-Shu
authors.initials: CS
authors.lastname: Chiu
mesh_terms: D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome