Abstract：
OBJECTIVE: Considerable debates exist regarding the preferable technique to repair a paediatric inguinal hernia (PIH). This systematic review aims to compare the efficacy and safety of laparoscopic herniorrhaphy (LH) and open herniorrhaphy (OH) in PIH.
METHODS: The randomised controlled trials (RCTs) that compared the outcomes of LH and OH in PIH without region and language restrictions searched from the following databases: PubMed, Web of Science Database, Cochrane Library, SciELO Citation Index, Russian Science Citation Index, China National Knowledge Infrastructure, WanFang Data and China Science and Technology Journal Database.
RESULTS: A total of 13 RCTs that involving 1207 patients included in the review. The LH displayed a shorter operative time for bilateral hernia repair (weighted mean difference = -8.23, 95% confidence interval [CI]: -11.22~-5.23, P < 0.00001), a lower complication rate (odds ratio [OR] = 0.32, 95% CI: 013-0.83, P = 0.02) along with a lower wound infection (OR = 0.14, 95% CI: 0.04-0.55, P = 0.005) and major male-specific post-operative complications (OR = 0.10, 95% CI: 0.04-0.24, P < 0.00001) and a less contralateral metachronous inguinal hernia (CMIH) incidence rate (OR = 0.09, 95% CI: 0.02-0.42, P = 0.002). No significant difference was found for unilateral operative time, time to full recovery, length of hospital stay, recurrence and hydrocele rates between the two techniques.
CONCLUSIONS: The present review reiterates that both the LH and OH techniques for the PIH repair are comparable. However, in some aspects, the LH is superior to the OH in terms of operative time for bilateral hernias, post-operative complications rate and CMIH incidence rate. Rigorously designed RCTs are anticipated to confirm the clinical effects of both LH and OH.
METHODS: The randomised controlled trials (RCTs) that compared the outcomes of LH and OH in PIH without region and language restrictions searched from the following databases: PubMed, Web of Science Database, Cochrane Library, SciELO Citation Index, Russian Science Citation Index, China National Knowledge Infrastructure, WanFang Data and China Science and Technology Journal Database.
RESULTS: A total of 13 RCTs that involving 1207 patients included in the review. The LH displayed a shorter operative time for bilateral hernia repair (weighted mean difference = -8.23, 95% confidence interval [CI]: -11.22~-5.23, P < 0.00001), a lower complication rate (odds ratio [OR] = 0.32, 95% CI: 013-0.83, P = 0.02) along with a lower wound infection (OR = 0.14, 95% CI: 0.04-0.55, P = 0.005) and major male-specific post-operative complications (OR = 0.10, 95% CI: 0.04-0.24, P < 0.00001) and a less contralateral metachronous inguinal hernia (CMIH) incidence rate (OR = 0.09, 95% CI: 0.02-0.42, P = 0.002). No significant difference was found for unilateral operative time, time to full recovery, length of hospital stay, recurrence and hydrocele rates between the two techniques.
CONCLUSIONS: The present review reiterates that both the LH and OH techniques for the PIH repair are comparable. However, in some aspects, the LH is superior to the OH in terms of operative time for bilateral hernias, post-operative complications rate and CMIH incidence rate. Rigorously designed RCTs are anticipated to confirm the clinical effects of both LH and OH.
摘要：
目的：关于小儿腹股沟疝（PIH）的首选修复技术存在相当多的争论。本系统评价旨在比较腹腔镜疝修补术（LH）和开放疝修补术（OH）在PIH中的疗效和安全性。
方法：比较LH和OH在没有地区和语言限制的PIH中结局的随机对照试验（RCT）从以下数据库中搜索：PubMed，WebofScience数据库,科克伦图书馆,SciELO引文索引,俄罗斯科学引文索引,中国国家知识基础设施，万方数据与中国科技期刊数据库
结果：本综述共纳入13项RCTs，涉及1207例患者。LH显示双侧疝修补术的手术时间较短（加权平均差=-8.23，95％置信区间[CI]：-11.22〜-5.23，P<0.00001）。较低的并发症发生率（比值比[OR]=0.32，95％CI：013-0.83，P=0.02）以及较低的伤口感染（OR=0.14，95％CI：0.04-0.55，P=0.005）和主要的男性特异性手术后并发症（OR=0.10，95％CI：0.04-0.24，P<0.00001），对侧腹股沟疝发生率较低（CMIH=0.单侧手术时间无显著差异，完全康复的时间，住院时间,两种技术之间的复发率和鞘膜积液率。
结论：本综述重申LH和OH技术在PIH修复中具有可比性。然而,在某些方面,在双侧疝的手术时间方面，LH优于OH，术后并发症发生率和CMIH发生率。预计严格设计的RCT可确认LH和OH的临床效果。
方法：比较LH和OH在没有地区和语言限制的PIH中结局的随机对照试验（RCT）从以下数据库中搜索：PubMed，WebofScience数据库,科克伦图书馆,SciELO引文索引,俄罗斯科学引文索引,中国国家知识基础设施，万方数据与中国科技期刊数据库
结果：本综述共纳入13项RCTs，涉及1207例患者。LH显示双侧疝修补术的手术时间较短（加权平均差=-8.23，95％置信区间[CI]：-11.22〜-5.23，P<0.00001）。较低的并发症发生率（比值比[OR]=0.32，95％CI：013-0.83，P=0.02）以及较低的伤口感染（OR=0.14，95％CI：0.04-0.55，P=0.005）和主要的男性特异性手术后并发症（OR=0.10，95％CI：0.04-0.24，P<0.00001），对侧腹股沟疝发生率较低（CMIH=0.单侧手术时间无显著差异，完全康复的时间，住院时间,两种技术之间的复发率和鞘膜积液率。
结论：本综述重申LH和OH技术在PIH修复中具有可比性。然而,在某些方面,在双侧疝的手术时间方面，LH优于OH，术后并发症发生率和CMIH发生率。预计严格设计的RCT可确认LH和OH的临床效果。
