The clinical outcomes of pediatric inguinal hernia repairs operated by surgical residents

Yoshimura, Shohei; Migita, Misato; Matsufuji, Hiroshi

doi:10.1016/j.asjsur.2019.08.011

Cited by 8 publications

(5 citation statements)

References 10 publications

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“…Open IHR is an operation that is taught to the pediatric surgical trainee under direct supervision in the operation room. It is one of the first surgeries a trainee performs [29]. Laparoscopic IHR needs different training, but skills could be acquired within 12 months according to a Japanese study [30].…”

Section: Discussionmentioning

confidence: 99%

The Status of Laparoscopic Inguinal Hernia Surgery in Children: A Nationwide Assessment

et al. 2022

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Inguinal hernia repair (IHR) is a common procedure in childhood. Laparoscopic IHR has been evolving for the last three decades. Although clear advantages have been shown, adaptation in Germany has been slow. We aim to study the current status of pediatric laparoscopic IHR. A survey was sent to all 89 pediatric surgical departments in Germany on current practices and preferences of open versus laparoscopic IHR. Two nationwide databases of administrative claims data from 2019 were analyzed and correlated with responses from the survey. A total of 56% of the pediatric surgical departments supplied data through the quality reports. The recall of our survey was 58% of all pediatric surgery departments. According to the pooled data, laparoscopic IHR was performed in 8.2% of all inpatients treated. Laparoscopic IHR was considered a training procedure in 48% of the departments. Five different laparoscopic techniques were described (most commonly percutaneous closure of the hernia under laparoscopic vision). The choice between open and laparoscopic IHR was mainly determined by the child’s age. Currently, only a minority of German children undergo inguinal hernia repair by laparoscopy. More training opportunities in the form of hands-on and video workshops may lead to more widespread employment of the laparoscopic technique.

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Section: Discussionmentioning

confidence: 99%

The Status of Laparoscopic Inguinal Hernia Surgery in Children: A Nationwide Assessment

et al. 2022

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“…The reduction in numbers from hernioplasty towards herniorrhaphy in the study period may be closely linked to the shift of operations performed by paediatric surgeons, because a survey among general and paediatric surgeons showed that general surgeons were much more likely than paediatric surgeons to choose an adult-type hernia repair with either muscle hernioplasty or mesh-implantation [ 38 ]. This suggests a tendency to stick with the approach that one is proficient with, because there is a relevant learning curve to learn the open [ 39 ] or the transabdominal laparoscopic approach [ 40 ]. Taking into account the steadily increasing number of paediatric surgeons in Germany [ 41 ] would support the notion that their expertise in treating children becomes more broadly available and thus supplant adult surgeons using their approach of hernioplasty.…”

Section: Discussionmentioning

confidence: 99%

Inguinal hernia repair in inpatient children: a nationwide analysis of German administrative data

et al. 2021

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Background Contrary to adult inguinal hernia surgery, large-scale investigations using registries or administrative data are missing in paediatric surgery. We aimed to fill this gap by analysing German administrative hospital data to describe the current reality of inpatient hernia surgery in children. Methods We analysed aggregated data files bought from the German federals statistics office on hospital reimbursement data separately for principal diagnoses of inguinal hernia in children and for herniotomies in inpatients. Developments over time were assessed via regression and differences between groups with nonparametric comparisons. Results Principal diagnoses of hernias were decreasing over time with the exception of male bilateral and female bilateral incarcerated hernias in the first year of life which increased. The vast majority of operations were conducted via the open approach and laparoscopy was increasingly only used for females older than 1 year of age. Recurrent hernia repair was scarce. Rates of inguinal hernia repair were higher in both sexes the younger the patient was, but were also decreasing in all age groups despite a population growth since 2012. The amount of inguinal hernia repairs by paediatric surgeons compared to adult surgeons increased by 1.5% per year. Conclusions Our results corroborate previous findings of age and sex distribution. It demonstrates that inpatient hernia repair is primarily open surgery with herniorrhaphy and that recurrences seem to be rare. We observed decreasing rates of hernia repairs over time and as this has been described before in England, future studies should try to elucidate this development. Level of evidence III.

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“…Complications arising from inguinal hernia repair may depend on the expertise of the surgeon and state of the hernia (complicated/uncomplicated). For instance, a study from Japan reported a high complication rate of 11.5% when the inguinal hernia is repaired by resident doctors as compared to when the repair is performed by consultants 5 . A study from Ilorin, Nigeria reported a complication rate of 24.4% following repair of complicated inguinal hernia 12 .…”

Section: Discussionmentioning

confidence: 99%

“…It is estimated that 0.8% to 4.4% of children will develop inguinal hernia during the process of their growth 3 . Inguinal hernia repair is one of the most frequent operations in pediatric surgery and is also essential for the surgical training of resident doctors as a basic surgical skills 4,5 . In choosing the appropriate method of inguinal hernia repair, the pediatric surgeon considers the complications and outcome of each method.…”

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confidence: 99%

Complications of inguinal hernia repair in children: A tertiary hospital experience

Emeka¹

2020

J. Kathmandu Med. Coll.

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Background: Repair of inguinal hernia is one of the most frequently performed procedures in pediatric surgery. Objective: The aim of this study was to evaluate the complications we encountered following repair of inguinal hernia in children. Methodology: This was a retrospective study done in children aged 15 years and below who had complications following inguinal hernia repair (both emergency and elective) at the pediatric surgery unit of Enugu State University Teaching Hospital (ESUTH) Enugu, Nigeria, between January 2014 and December 2018. Results: A total of 1243 cases of pediatric inguinal hernia repairs were performed during the study period. Out of this, 123 patients developed complications, accounting for 9.9% of the total cases. There was male predominance with a median age of 1 year. Most of the complications were noted in infants undergoing emergency repairs. Scrotal complications were the most common complications which resolved on non-operative treatment. Other complications in descending order of frequency included wound infection, hernia recurrence, testicular atrophy and sensory disturbances in the inguinal region. There was no mortality following the surgeries. Conclusion: Pediatric inguinal hernia repair is a procedure with potential complications more so in infants following an emergency repair. Preoperative parental counseling and timely referral are mandatory.

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The clinical outcomes of pediatric inguinal hernia repairs operated by surgical residents

Cited by 8 publications

References 10 publications

The Status of Laparoscopic Inguinal Hernia Surgery in Children: A Nationwide Assessment

The Status of Laparoscopic Inguinal Hernia Surgery in Children: A Nationwide Assessment

Inguinal hernia repair in inpatient children: a nationwide analysis of German administrative data

Complications of inguinal hernia repair in children: A tertiary hospital experience

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