Clinical Scorecard: Minimal Rates of Recurrence and Chronic Pain Following Groin Hernia Surgery in Adolescents: A Systematic Review and Meta-Analysis
At a Glance
Category
Detail
Condition
Groin hernia in adolescents
Key Mechanisms
Surgical repair via open or laparoscopic methods using mesh or sutures; concerns about mesh use in growing tissue
Target Population
Adolescents aged 10–17 years undergoing primary unilateral or bilateral groin hernia repair
Care Setting
Surgical care in pediatric and adult surgical settings
Key Highlights
Adolescents represent a heterogeneous group with variable physical maturity affecting surgical approach decisions.
Mesh use lowers recurrence rates in adults but may increase chronic postoperative pain, especially in young males; evidence in adolescents is limited.
Current surgical approach in adolescents is based on surgeon preference and patient/parent collaboration, with open repair preferred by pediatric surgeons.
Guideline-Based Recommendations
Diagnosis
Recurrence should be assessed by physical examination or diagnostic imaging; self-reported recurrence is insufficient.
Postoperative chronic pain should be evaluated at least 6 months after surgery.
Management
Surgical repair can be open or laparoscopic, with or without mesh, tailored to patient age and surgeon expertise.
Consider patient growth and potential long-term foreign body effects when deciding on mesh use in adolescents.
Monitoring & Follow-up
Follow-up should include assessment for hernia recurrence and chronic pain beyond 6 months postoperatively.
Monitor for postoperative complications and chronic pain, especially in late adolescence.
Risks
Mesh use may increase risk of chronic postoperative pain in late adolescents (18–21 years).
Young adult males have higher risk of chronic pain after inguinal hernia repair.
Patient & Prescribing Data
Males and females aged 10–17 years undergoing groin hernia repair
Mesh reduces recurrence but may be associated with chronic pain; decision to use mesh should balance recurrence risk and potential for chronic pain.
Clinical Best Practices
Define adolescents as 10–17 years to guide surgical approach distinct from pediatric and adult populations.
Use standardized methods for assessing recurrence and chronic pain to ensure reliable outcome measurement.
Engage patients and parents in surgical decision-making considering physical maturity and potential risks.
Prefer open repair in pediatric surgeons; consider laparoscopic approach based on surgeon expertise and patient factors.
Conduct long-term follow-up to monitor for recurrence and chronic pain.
