COMPARISON OF NEEDLE ASSISTED LAPAROSCOPIC REPAIR AND OPEN REPAIR OF INGUINAL HERNIA IN PAEDIATRIC POPULATION: A RANDOMIZED CONTROLLED TRIAL
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Abstract
OBJECTIVE: To compare needle assisted laparoscopic repair (NALR) of inguinal hernia in children with open hernia repair (OHR).
METHODS: This randomized controlled trial was conducted at the Paediatric Surgery Unit of Khyber Teaching Hospital, Peshawar, Pakistan from Feburary 2017 to September 2018. Children aged upto 16 years and diagnosed with reducible inguinal hernia were randomized into two-groups; NALR and OHR. Obstructed inguinal hernia and cases which presented with recurrence were excluded from this study. Demographic and clinical data was collected and analysed using SPSS 20.
RESULTS: One hundred and fifteen patient were included in the study with NALR (n=50) and OHR group (n=65). NALR group included unilateral (n=35), bilateral hernia (n=5), PPV (n=10). OHR group included unilateral (n=55), bilateral (n=10). The mean age for NALR was 2.96±2.5 years and OHR was 4.17±3.62 years. Mean weight for NALR group was 11±6kg and OHR was 7.6±3.7kg. Operating time for unilateral NALR was 12±2.4 minutes and OHR was 24±3.8 minutes while bilateral NALR was 18.3±3.1 minutes and OHR was 32±6.3 minutes. Hospital stay for NALR group was 40±6.8 hours and OHR was 30±7.7 hours. Analgesia doses for unilateral NALR (4.5±1.2) were less than OHR (6.96±1.8) (p=0.02) and same is the case for bilateral repair (p=0.03). OHR had a high rate of postoperative complications; surgical site edema (14%), wound infection (4%) and recurrence (2.8%).
CONCLUSION: NALR is a safe and reliable substitute to OHR in terms of less operating time, minimum hospital stay, less doses of analgesia required and low rate of postoperative complications.
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