Laparoscopic internal loop ligation in treatment of children with recurrent indirect inguinal hernia

Objective To evaluate the advantages and surgical experience of laparoscopic internal loop ligation in treatment of recurrent indirect indirect inguinal hernia in children. Methods From January 2013 to January 2018, a total of 34 children with recurrent indirect inguinal hernia admitted to the Guangzhou Women and Children′s Medical Center were selected as research subjects. Clinical cases data were analyzed retrospectively. According to the surgical treatment adopted this time, they were divided into laparoscopic group (n=19, by laparoscopic internal loop ligation) and open surgery group (n=15, by high ligation of hernia sac). Independent-samples t test and chi-square test were used to compare the general clinical data, intraoperative and postoperative situation between two groups of children. This study was in line with World Medical Association Declaration of Helsinki revised in 2013. All guardians of the children signed informed consents for surgery before surgery. Results ①There were 3 patients developed scrotal hematoma, and 1 patient developed iatrogenic cryptorchidism after operation in open surgery group. None of the other complications such as wound infection, testicular atrophy, scrotal hydrocele and recurrence occurred in two groups. ②There were no significant differences between two groups in the proportion of male children, age and the proportion of laparoscopic surgery for the first time (P>0.05). The duration operation, intraoperative blood loss volume, duration of hospital stay and postoperative complication rate in laparoscopic group were (30.0±10.7) min, (1.0±0.3) mL, (1.2±0.4) d, and 0, respectively, which were shorter or less than those of (44.7±24.5) min, (2.3±1.3) mL, (3.3±1.0) d and 26.7% in open surgery group; while the hospitalization costs of (7 547±820) yuan in laparoscopic group was higher than that of (5 488±1 218) yuan in open surgery group, and these differences were statistically significant (t=-2.347, P=0.044; t=-3.859, P=0.002; t=-8.171, P<0.001; P=0.029; t=5.580, P<0.001). Conclusions Laparoscopic internal loop ligation for the treatment of recurrent inguinal hernia in children has the advantages of safe and effective, good intraoperative condition and less postoperative complications, but the hospitalization cost was higher. Key words: Laparoscopes; Hernia, inguinal; Recurrence; Ligation; Child