title: Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernias and hydroceles in children: a comparison with traditional open repair.
abstract: BACKGROUND
  Laparoscopic procedures for inguinal hernias and hydroceles in children have become widespread in the past few decades. The purpose of this study was to perform a retrospective analysis of our experience in order to assess the safety and efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC) and to compare the findings with those of conventional open repair (OR).
  
  
  METHODS
  We analyzed the medical records of 488 patients who underwent LPEC or OR for inguinal hernia or hydrocele at our institute between April 2008 and December 2012. The indications for the operation, length of the operation, complications, day surgery, contralateral patent processus vaginalis, and incidence of metachronous contralateral hernia were investigated. The chi-squared test, unpaired t test, and Steel-Dwass test were used to analyze the significance of the data.
  
  
  RESULTS
  Among a total of 488 patients, 326 patients underwent LPEC (125 males and 201 females), and 162 underwent OR (140 males and 22 females). There was no significant difference in the incidence of recurrence (three in the LPEC and none in the OR group, P=.55) or in the success rates of day surgery (97.8% in LPEC versus 97.6% in OR). The incidence of metachronous contralateral hernias in the LPEC group was lower than that in the OR group (LPEC 0%; OR 2.2%, P=.03). Seventeen subjects with hydroceles were treated by LPEC without any complications.
  
  
  CONCLUSIONS
  LPEC is safe and effective for inguinal hernias and hydroceles in children, regardless of age, sex, and incarceration and could reduce the incidence of metachronous contralateral hernias.
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine , Hyogo, Japan .
authors.forename: Ryuta
authors.initials: R
authors.lastname: Saka
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Okuyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Satoko
authors.initials: S
authors.lastname: Nose
authors.forename: Chizu
authors.initials: C
authors.lastname: Yoneyama
mesh_terms: D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D061646:Operative Time; D012008:Recurrence; D012189:Retrospective Studies; D006848:Testicular Hydrocele / Q000601:surgery*; D016896:Treatment Outcome; D013519:Urogenital Surgical Procedures / Q000379:methods*