Laparoscopic percutaneous extraperitoneal closure versus open repair in pediatric inguinal hernia: a systematic review and meta-analysis of comparative outcomes
- 01.12.2026
- Original Article
Erschienen in:
- Verfasst von
- Masaya Yamoto
- Toshiaki Takahashi
- Yoshiki Morotomi
- Itsurou Nagae
- Hiroo Takehara
- Erschienen in
- Hernia | Ausgabe 1/2026
Abstract
Purpose
Pediatric inguinal hernia is one of the most frequent surgical conditions in children. Conventional open repair (OHR) has been regarded as the standard approach for decades; however, laparoscopic percutaneous extraperitoneal closure (LPEC), first described in Japan, has emerged as a minimally invasive alternative. This study aimed to systematically compare the clinical outcomes of LPEC with those of OHR in pediatric patients.
Methods
A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines (PROSPERO CRD42022349660). PubMed, Ichushi-Web, and Google Scholar were searched up to May 2022. Eligible studies included randomized and observational comparisons of LPEC (or equivalent percutaneous closure techniques) versus OHR in patients under 18 years. Outcomes assessed were recurrence, contralateral metachronous hernia (CMH), postoperative testicular ascent, and operative time for unilateral and bilateral repair. Study quality was evaluated using ROBINS-I, and certainty of evidence graded using GRADE methodology. Pooled odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) were calculated.
Results
Ten studies with nearly 15,000 children were included. Recurrence did not differ significantly between LPEC and OHR (OR 1.34, 95% CI 0.84–2.16; I2 = 0%). LPEC was associated with significantly lower risk of CMH (OR 16.53, 95% CI 10.13–26.98; I2 = 0%) and testicular ascent (OR 2.51, 95% CI 1.11–5.67; I2 = 0%). Unilateral LPEC required slightly longer operative time (MD + 3.11 min, 95% CI 2.53–3.70), while bilateral repairs were modestly faster (MD –6.21 min, 95% CI –8.02 to –4.40).
Conclusions
LPEC achieves recurrence outcomes equivalent to OHR while reducing contralateral hernia and testicular ascent, and improving efficiency in bilateral repairs. These findings support LPEC as a safe and effective first-line option for pediatric inguinal hernia.
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- Titel
- Laparoscopic percutaneous extraperitoneal closure versus open repair in pediatric inguinal hernia: a systematic review and meta-analysis of comparative outcomes
- Verfasst von
-
Masaya Yamoto
Toshiaki Takahashi
Yoshiki Morotomi
Itsurou Nagae
Hiroo Takehara
- Publikationsdatum
- 01.12.2026
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2026
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03561-y
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