AIM: The aim of this study is to determine whether laparoscopic repair (LR) of inguinal hernia is superior to open repair (OR) in bilateral cases. SUBJECTS AND METHODS: Sixty-two boys older than 6 years with bilateral hernias were included in our prospective, randomized, single-blinded clinical trial. All patients were administered morphine via patient-controlled analgesia for 24 hours. Pain scores were evaluated by the patients using a visual analog scale (VAS) at 1, 2, 4, 12, and 24 hours postoperatively. Operative time, pain scores, analgesic doses, and first mobilization attempt were evaluated. Parents also provided assessments of their children's recovery and wound appearance. RESULTS:Operative time was found to be slightly higher in OR compared with LR. VAS scores were higher in OR than in LR at 1 hour postoperatively (6.78 versus 3.88, respectively; P<.05). At the other times, VAS scores showed no significant differences. Although OR patients requested and delivered analgesics more frequently than LR patients, the difference was not significant. The scores given by parents for wound appearance were significantly higher in the bilateral LR group than in the bilateral OR group (89±4.23 and 78±6.7, respectively; P<.05). CONCLUSIONS: This trial demonstrates that LR in bilateral cases offers benefits compared with OR in terms of lower pain scores and analgesic requirements and of reduced operative and patient recovery times. However, the only significant difference was better wound cosmesis in bilateral LR cases.
RCT Entities:
AIM: The aim of this study is to determine whether laparoscopic repair (LR) of inguinal hernia is superior to open repair (OR) in bilateral cases. SUBJECTS AND METHODS: Sixty-two boys older than 6 years with bilateral hernias were included in our prospective, randomized, single-blinded clinical trial. All patients were administered morphine via patient-controlled analgesia for 24 hours. Pain scores were evaluated by the patients using a visual analog scale (VAS) at 1, 2, 4, 12, and 24 hours postoperatively. Operative time, pain scores, analgesic doses, and first mobilization attempt were evaluated. Parents also provided assessments of their children's recovery and wound appearance. RESULTS: Operative time was found to be slightly higher in OR compared with LR. VAS scores were higher in OR than in LR at 1 hour postoperatively (6.78 versus 3.88, respectively; P<.05). At the other times, VAS scores showed no significant differences. Although OR patients requested and delivered analgesics more frequently than LR patients, the difference was not significant. The scores given by parents for wound appearance were significantly higher in the bilateral LR group than in the bilateral OR group (89±4.23 and 78±6.7, respectively; P<.05). CONCLUSIONS: This trial demonstrates that LR in bilateral cases offers benefits compared with OR in terms of lower pain scores and analgesic requirements and of reduced operative and patient recovery times. However, the only significant difference was better wound cosmesis in bilateral LR cases.
Authors: Colin D Gause; Maria G Sacco Casamassima; Jingyan Yang; Grace Hsiung; Daniel Rhee; Jose H Salazar; Dominic Papandria; Howard I Pryor; Dylan Stewart; Jeffrey Lukish; Paul Colombani; Nicole M Chandler; Emilie Johnson; Fizan Abdullah Journal: Pediatr Surg Int Date: 2016-12-26 Impact factor: 1.827