Laparoscopic Versus Open Hernia Repair for Indirect Inguinal Hernia in Adolescents: A Retrospective Cohort Study

Introduction: The optimal operative strategy for managing inguinal hernia (IH) in the adolescent population remains undetermined. This investigation sought to analyse and contrast the short-term perioperative results and the durable long-term prognosis among young patients suffering from IH who were treated either with minimally invasive laparoscopic hernia repair (LHR) or conventional open hernia repair (OHR). Methodology: This was a retrospective cohort study examining historical clinical and pathological characteristics of adolescent IH patients who initially received either LHR or OHR at VIMSAR, Burla between March 2018 and February 2024. Prognostic indicators associated with patient survival and outcome were isolated using univariate and subsequently multivariate Cox regression modelling. To mitigate potential selection bias, Propensity Score Matching (PSM) analysis was implemented to establish equivalent cohorts of patients from the LHR and OHR groups, matching them in a 1:1 ratio. Results: The initial cohort of adolescent IH patients comprised 122 individuals in the LHR group and 126 individuals in the OHR group. Following the execution of PSM, 94 patients were successfully matched in each study arm. Relative to the OHR cohort, the LHR group exhibited numerous advantages, including a shorter duration of hospital stay, reduced intraoperative haemorrhage, a lower incidence of total postoperative morbidities, and decreased rates of both recurrence and persistent postsurgical pain. Furthermore, the LHR cohort demonstrated markedly improved recurrence-free survival compared to the OHR group, a finding confirmed both prior to and following the PSM procedure. Conclusion: Laparoscopic management of inguinal hernia in adolescent patients represents a viable and safe therapeutic option, consistently yielding superior perioperative measures and favourable long-term outcomes.