Abstract：
Aim: Since the first description of laparoscopic herniorrhaphy (LH), a lot of studies have compared outcomes between LH and open herniorrhaphy (OH) with inconsistent results. We designed this study to assess outcomes between both techniques now that pediatric surgeons have enough confidence with it. Methods: We performed a systematic review and meta-analysis of articles published in the last 10 years. Results: Twenty-seven articles reporting on 91,653 patients (26,920 LH and 64,733 OH) were included. No significant differences were found in overall operative time (OT) (P = .07). Subgroup analysis revealed significantly shorter OT for LH in unilateral (-8.87 minutes, P = .03) and bilateral hernias (-16.86 minutes, P = .004), but longer in unilateral hernias in females (+7.47 minutes, P = .006). Recurrence rate was similar (odds ratio [OR] 1.05, P = .66). Less complications were reported in LH (OR 0.51, P = .03). Contralateral patent processus vaginalis average rate was 39.61% and its closure reported a significant decrease of contralateral metachronous hernia (OR 0.11, P < .00001). Conclusion: Although OH is still considered the gold standard by some authors, LH has proven to be not only as safe as OH but also to have additional advantages that should make pediatric surgeons implement it in their daily practice and not in selected cases alone.
摘要：
目的：自从首次描述腹腔镜疝修补术（LH）以来，许多研究比较了LH和开放性疝修补术(OH)的结局,但结果不一致.我们设计了这项研究来评估两种技术之间的结果，因为儿科外科医生对此有足够的信心。方法：我们对最近10年发表的文章进行了系统评价和荟萃分析。结果：包括27篇报告91,653例患者（26,920名LH和64,733名OH）的文章。总手术时间（OT）无显著差异（P=0.07）。亚组分析显示，单侧LH的OT显着缩短（-8.87分钟，P=.03）和双侧疝（-16.86分钟，P=.004)，但女性单侧疝的时间更长(+7.47分钟，P=.006）。复发率相似（比值比[OR]1.05，P=0.66）。LH中报告的并发症较少（OR0.51，P=0.03）。对侧阴道未闭平均发生率为39.61％，其闭合报告对侧异时性疝明显减少（OR0.11，P<.00001）。结论：虽然OH仍然被一些作者认为是黄金标准，LH已被证明不仅与OH一样安全，而且还具有其他优势，可以使儿科外科医生在日常实践中而不是仅在某些情况下实施LH。
