Comparison of Laparoscopic Percutaneous Extraperitoneal Closure and Conventional Open Inguinal Hernia Repair for Inguinal Hernia in Children: A Meta-Analysis.

OBJECTIVE

This study aimed to systematically evaluate the efficacy and safety of laparoscopic percutaneous extraperitoneal closure (LPEC) compared with conventional open inguinal hernia repair (OR) for inguinal hernia in children, and to provide high-quality evidence for clinical decision-making.

METHODS

Databases including PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to February 2026. Two reviewers independently performed literature screening, data extraction, and quality assessment. Meta-analyses were conducted using Rev Man 5.4 software.

RESULTS

Fifteen studies (14 retrospective cohort studies and 1 randomized controlled trial) were included. Meta-analysis demonstrated that, compared with OR, LPEC was associated with significantly shorter bilateral operation time (MD = -8.82, 95% CI -12.63 to -5.01, p < 0.00001), lower incidence of contralateral metachronous inguinal hernia (RR = 0.06, 95% CI 0.04 to 0.09, p < 0.00001), and lower incidence of testicular ascent (RR = 0.36, 95% CI 0.17 to 0.79, p = 0.01). Unilateral operation time was longer in the LPEC group (MD = 1.62, 95% CI 0.02 to 3.32, p = 0.05). No significant differences were observed between the two groups in recurrence rate (RR = 0.70, 95% CI 0.48 to 1.04, p = 0.08), postoperative hydrocele (RR = 0.49, 95% CI 0.24 to 1.02, p = 0.06), or incision infection (RR = 0.99, 95% CI 0.35 to 2.79, p = 0.99).

CONCLUSION

LPEC is superior to OR in shortening bilateral operative time and decreasing the risks of contralateral metachronous hernia and testicular ascent, with comparable recurrence and complication profiles. Despite slightly longer unilateral operative time, LPEC demonstrates favorable overall efficacy and may serve as the preferred surgical strategy for pediatric inguinal hernia.