담소유 학술 : Research Achievement of Damsoyu

Abstract

[Purpose]

Pediatric laparoscopic herniorrhaphy has rare complications,

but recurrence might occur. The purpose of this manuscript is to evaluate the efficacy of linear suture
technique of laparoscopic pediatric herniorrhaphy in reducing recurrences.

[Methods]

Laparoscopic surgery was performed on 2223 pediatric patients (under 10 years old) from September
2012 to December 2014 in Damsoyu Hospital, Seoul, Republic of Korea. The causes of recurrence were investigated
case by case. The patients were categorized into two groups according to the suture method used in closing
the hernia orifice: Group 1 (purse-string suture, 1009 patients) and Group 2 (linear suture, 1214 patients).

[Results]

There were 1413 (63.6%) male and 810 (36.4%) female patients. Mean age was 30.5 ± 29.2 months.

A significantly higher proportion of male patients, contralateral patent processus vaginalis, and less proportion of
recurrence were observed in Group 2. There were ten cases of recurrence in Group 1 because the internal ring suture
could not endure the tension. One recurrence occurred in Group 2. The suture technique and age were found to

be a significant risk factor for recurrence. Linear suture technique had a lower recurrence rate

(odds ratio = 0.07, with 95% confidence interval 0.01–0.53, and p = 0.004).

[Conclusions]

Purse-string suture technique causes significantly higher occurrence of hernia recurrences

than linear suture technique. Linear suture technique can reduce recurrence by increasing the endurance

to tension around the internal ring by distributing pressure to a wider area along the linear suture line.

Linear suture technique can effectively reduce recurrence in pediatric inguinal herniorrhaphy.