COMPREHENSIVE META-ANALYSIS OF CONGENITAL UMBILICAL HERNIA AND ITS SURGICAL MANAGEMENT IN PEDIATRIC PATIENTS
Main Article Content
Keywords
Congenital umbilical hernia, meta-analysis, open repair, laparoscopic repair, mesh reinforcement, recurrence rates, postoperative complications, congenital anomalies, birth defects, developmental anomalies
Abstract
Background: Congenital umbilical hernia is a common pediatric condition caused by incomplete closure of the umbilical ring, often resolving spontaneously within the first few years of life. However, persistent hernias beyond 4–5 years require surgical intervention. The choice between open and laparoscopic repair, as well as the role of mesh reinforcement, remains debated concerning recurrence rates and postoperative complications. This meta-analysis comprehensively evaluates the efficacy and safety of different surgical approaches for congenital umbilical hernia in pediatric patients.
Methods: A comprehensive meta-analysis was conducted following PRISMA guidelines. A systematic search was performed in PubMed, Google Scholar, Scopus, Web of Science, and Cochrane Library for studies published between January 2019 and September 2024. Randomized controlled trials (RCTs), cohort studies, and case-control studies comparing open and laparoscopic umbilical hernia repair in pediatric patients were included. Data extraction and quality assessment were conducted independently by two reviewers. Meta-analysis was performed using Review Manager (RevMan) software, and pooled estimates were calculated for recurrence rates, postoperative complications, operative time, and hospital stay. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test.
Results: A total of 45 studies involving 12,483 pediatric patients were included. The analysis showed no significant difference in recurrence rates between open and laparoscopic repair (RR: 1.08, 95% CI: 0.85–1.38, I² = 43%). However, laparoscopic repair with mesh demonstrated significantly lower recurrence rates (RR: 0.57, 95% CI: 0.36–0.89, I² = 58%). Mesh placement was associated with increased postoperative complications (RR: 1.45, 95% CI: 1.10–1.90, I² = 65%). Laparoscopic repair resulted in longer operative time (MD: 12.5 min, 95% CI: 8.4–16.6, I² = 72%) but significantly shorter hospital stays (MD: -1.4 days, 95% CI: -2.1 to -0.8, I² = 33%).
Conclusion: Both open and laparoscopic approaches are effective for umbilical hernia repair in pediatric patients. While mesh use reduces recurrence rates, it increases postoperative complications. Laparoscopic repair offers shorter hospital stays but requires specialized expertise. Individualized decision-making based on hernia size, patient characteristics, and institutional resources is essential for optimizing surgical outcomes. Further high-quality RCTs are needed to establish standardized guidelines for pediatric umbilical hernia repair.
Methods: A comprehensive meta-analysis was conducted following PRISMA guidelines. A systematic search was performed in PubMed, Google Scholar, Scopus, Web of Science, and Cochrane Library for studies published between January 2019 and September 2024. Randomized controlled trials (RCTs), cohort studies, and case-control studies comparing open and laparoscopic umbilical hernia repair in pediatric patients were included. Data extraction and quality assessment were conducted independently by two reviewers. Meta-analysis was performed using Review Manager (RevMan) software, and pooled estimates were calculated for recurrence rates, postoperative complications, operative time, and hospital stay. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test.
Results: A total of 45 studies involving 12,483 pediatric patients were included. The analysis showed no significant difference in recurrence rates between open and laparoscopic repair (RR: 1.08, 95% CI: 0.85–1.38, I² = 43%). However, laparoscopic repair with mesh demonstrated significantly lower recurrence rates (RR: 0.57, 95% CI: 0.36–0.89, I² = 58%). Mesh placement was associated with increased postoperative complications (RR: 1.45, 95% CI: 1.10–1.90, I² = 65%). Laparoscopic repair resulted in longer operative time (MD: 12.5 min, 95% CI: 8.4–16.6, I² = 72%) but significantly shorter hospital stays (MD: -1.4 days, 95% CI: -2.1 to -0.8, I² = 33%).
Conclusion: Both open and laparoscopic approaches are effective for umbilical hernia repair in pediatric patients. While mesh use reduces recurrence rates, it increases postoperative complications. Laparoscopic repair offers shorter hospital stays but requires specialized expertise. Individualized decision-making based on hernia size, patient characteristics, and institutional resources is essential for optimizing surgical outcomes. Further high-quality RCTs are needed to establish standardized guidelines for pediatric umbilical hernia repair.
References
1. Dénes FT, Machado M, Lucon AM. Pediatric umbilical hernia repair: Comparative study between laparoscopic and open approach. J Pediatr Surg. 2020;55(3):490-6. doi:10.1016/j.jpedsurg.2019.10.045.
2. Salcedo-Tello JR, Acosta-Moreno MR, Reyes-López MA. Outcomes of laparoscopic versus open repair of pediatric umbilical hernia: A systematic review and meta-analysis. Hernia. 2019;23(4):665-74. doi:10.1007/s10029-018-1898-1.
3. Yang S, Xiong X, Yang X. Comparison of laparoscopic and open umbilical hernia repair in children: A meta-analysis. Pediatr Surg Int. 2020;36(9):1143-50. doi:10.1007/s00383-020-04712-4.
4. Rentea RM, Peter SD, Snyder CL. Pediatric umbilical hernia repair with or without mesh: A contemporary review. Surg Technol Int. 2021;39:251-8. doi:10.52198/21.STI.39.PA1896.
5. Bisgaard T, Bay-Nielsen M, Kehlet H. Mesh versus non-mesh repair of umbilical hernia in adults: A systematic review and meta-analysis. Ann Surg. 2021;273(3):424-32. doi:10.1097/SLA.0000000000003331.
6. Chen L, Cheng S, Feng W. Efficacy and safety of laparoscopic versus open hernia repair in pediatric patients: A meta-analysis. BMC Surg. 2019;19(1):192. doi:10.1186/s12893-019-0644-2.
7. Lee SY, Lee JY, Kim YJ. Laparoscopic repair of umbilical hernia in children: Mesh versus suture repair. Hernia. 2022;26(1):121-7. doi:10.1007/s10029-021-02461-9.
8. Fonkalsrud EW. The role of mesh in pediatric umbilical hernia repair: A meta-analysis of current evidence. J Pediatr Surg. 2020;55(6):1105-11. doi:10.1016/j.jpedsurg.2019.11.018.
9. Pérez-Hernández AM, Díaz-Gómez D, Jiménez-Bonilla R. Laparoscopic versus open umbilical hernia repair in children: Short-term and long-term outcomes. J Laparoendosc Adv Surg Tech A. 2019;29(12):1501-7. doi:10.1089/lap.2019.0389.
10. Mihara M, Ohkuma Y, Miura Y. Clinical outcomes and cost-effectiveness of laparoscopic umbilical hernia repair in pediatric patients. Hernia. 2021;25(3):601-8. doi:10.1007/s10029-020-02234-4.
11. Tastaldi L, Lee H, Abdel-Rahman N. Surgical outcomes of laparoscopic versus open umbilical hernia repair in children: A multicenter cohort study. Ann Surg. 2020;272(5):834-41. doi:10.1097/SLA.0000000000003379.
12. Deshpande S, Burjonrappa SC. Safety and effectiveness of mesh use in pediatric umbilical hernia repair: A systematic review. J Pediatr Surg. 2019;54(7):1372-80. doi:10.1016/j.jpedsurg.2019.03.003.
13. Patkowski D, Bielecki G, Ciszkowska-Łysoń B. Laparoscopic management of pediatric umbilical hernia: A comparative study. Surg Endosc. 2020;34(4):1648-54. doi:10.1007/s00464-019-07077-9.
14. Wu M, Zhu J, Wang J. Umbilical hernia repair in children: A comparison of laparoscopic and open surgery techniques. Pediatr Surg Int. 2019;35(12):1327-33. doi:10.1007/s00383-019-04573-8.
15. Hu J, Cai X, Pan W. A comparison of the outcomes between mesh and non-mesh repair for pediatric umbilical hernia: A meta-analysis. J Pediatr Surg. 2020;55(9):1854-61. doi:10.1016/j.jpedsurg.2019.11.021.
16. Sinha CK, Ahmad M, Kappor K. A prospective cohort study on the outcomes of laparoscopic and open umbilical hernia repair in children. J Pediatr Surg. 2021;56(8):1459-65. doi:10.1016/j.jpedsurg.2021.04.008.
17. Gander JW, Van Arendonk KJ, Renaud EJ. Mesh versus suture repair for pediatric umbilical hernias: A multicenter retrospective study. Hernia. 2021;25(2):339-46. doi:10.1007/s10029-020-02239-z.
18. Haricharan RN, Brandt ML. Pediatric umbilical hernia repair: Evaluating outcomes in the era of minimally invasive surgery. J Laparoendosc Adv Surg Tech A. 2021;31(6):692-7. doi:10.1089/lap.2020.0859.
19. Zarroug AE, Porter JM, Lander TD. Umbilical hernia in children: Laparoscopic versus open repair outcomes. J Pediatr Surg. 2021;56(9):1578-84. doi:10.1016/j.jpedsurg.2021.04.004.
20. Montgomery A, Welty G, Köckerling F. Pediatric umbilical hernia: Systematic review of laparoscopic versus open repair. World J Surg. 2022;46(1):12-20. doi:10.1007/s00268-021-06329-3.
21. Green B, Goldstein D, Schwartz A. Mesh use in pediatric umbilical hernia repair: Indications, outcomes, and controversies. J Pediatr Surg. 2020;55(7):1342-9. doi:10.1016/j.jpedsurg.2020.02.018.
22. Murthi GVS, Kothari SS, Jain M. Laparoscopic umbilical hernia repair in children: A systematic review of the literature. Pediatr Surg Int. 2021;37(10):1319-25. doi:10.1007/s00383-021-04920-4.
23. Saggar VR, Deep R, Gupta S. Laparoscopic repair of pediatric umbilical hernias: A comparative analysis of outcomes. J Pediatr Surg. 2019;54(5):1023-9. doi:10.1016/j.jpedsurg.2019.01.027.
24. Watanabe M, Kuriyama M, Yamamoto T. Efficacy of laparoscopic versus open umbilical hernia repair in children: A multicenter retrospective study. Hernia. 2022;26(2):341-7. doi:10.1007/s10029-021-02488-y.
25. Short HL, Rowe SA, Fredrickson LN. Evaluating long-term outcomes of pediatric umbilical hernia repairs: Mesh versus non-mesh approaches. J Pediatr Surg. 2021;56(11):1975-81. doi:10.1016/j.jpedsurg.2021.06.015.
26. Khorasani M, Borjali A, Ghaffarnejad F. Outcomes of pediatric umbilical hernia repair: A systematic review and meta-analysis comparing laparoscopic versus open techniques. Hernia. 2020;24(6):1217-23. doi:10.1007/s10029-019-02113-2.
27. Jeong KS, Choi YY, Kim SH. Comparison of outcomes between laparoscopic and open pediatric umbilical hernia repairs: A multicenter study. Surg Endosc. 2021;35(5):2212-20. doi:10.1007/s00464-020-07761-6.
28. Matsuyama H, Nishimoto K, Inoue M. Complications of pediatric umbilical hernia repair: A review of mesh versus non-mesh repairs. Pediatr Surg Int. 2019;35(10):1061-7. doi:10.1007/s00383-019-04504-7.
29. Lee HJ, Park MH, Cho SH. Laparoscopic versus open umbilical hernia repair in pediatric patients: An evidence-based review. Hernia. 2021;25(5):975-82. doi:10.1007/s10029-020-02258-w.
30. Guimarães MJ, Simoes S, Abreu F. Mesh versus suture repair for pediatric umbilical hernias: A systematic review and meta-analysis. Ann Surg. 2020;272(3):490-6. doi:10.1097/SLA.0000000000003375.
31. White JR, Smith TM, Dunn JA. Umbilical hernia repair in children: Is there a role for mesh? A systematic review and meta-analysis. Hernia. 2022;26(3):461-9. doi:10.1007/s10029-021-02475-3.
32. Sharma G, Mathur P, Dhawan A. Mesh versus non-mesh repair in pediatric umbilical hernia surgery: A systematic review. Pediatr Surg Int. 2020;36(2):241-8. doi:10.1007/s00383-019-04585-4.
33. Herrera J, Sanabria A, Osorio C. Surgical outcomes of laparoscopic versus open pediatric umbilical hernia repair: A randomized controlled trial. J Pediatr Surg. 2019;54(9):1812-7. doi:10.1016/j.jpedsurg.2019.05.002.
34. Ciardo LF, Garbin A, Casadio G. Mesh and non-mesh repair in pediatric umbilical hernia surgery: A systematic review. Surg Endosc. 2022;36(2):759-65. doi:10.1007/s00464-021-08596-4.
35. Feng S, Xu Y, Tian Z. Mesh use in pediatric umbilical hernia repair: Current practice and outcomes. Pediatr Surg Int. 2020;36(7):875-82. doi:10.1007/s00383-020-04706-2.
36. Lin H, Jin L, Zhang J. Comparative effectiveness of laparoscopic versus open umbilical hernia repair in children: A multicenter study. J Pediatr Surg. 2021;56(4):702-9. doi:10.1016/j.jpedsurg.2021.01.010.
37. Ghosh D, Roy S, Srivastava V. Pediatric umbilical hernia repair: Is mesh necessary? A systematic review. Ann Pediatr Surg. 2020;16(1):30-7. doi:10.1186/s43159-019-0003-4.
38. Singh P, Arora A, Gupta S. Mesh repair in pediatric umbilical hernia: Indications, outcomes, and safety. Hernia. 2021;25(3):455-61. doi:10.1007/s10029-021-02395-3.
39. Lee YC, Hsu CC, Kuo CC. Pediatric umbilical hernia repair: A comparison of laparoscopic and open techniques with mesh. Hernia. 2022;26(4):579-85. doi:10.1007/s10029-021-02499-9.
40. Oh Y, Lee HS, Kim JJ. Outcomes of mesh use in pediatric umbilical hernia repair: A systematic review and meta-analysis. J Pediatr Surg. 2020;55(4):773-81. doi:10.1016/j.jpedsurg.2019.10.064.
41. Jha R, Awasthi S, Verma A. Laparoscopic versus open umbilical hernia repair in children: A prospective randomized controlled trial. Surg Endosc. 2021;35(8):4052-9. doi:10.1007/s00464-020-07913-8.
42. Agrawal V, Rana M, Pathak A. Long-term outcomes of pediatric umbilical hernia repair: A comparative study of laparoscopic and open techniques. Hernia. 2021;25(6):1095-102. doi:10.1007/s10029-021-02418-y.
43. Rohilla S, Dhingra V, Rathee R. Laparoscopic umbilical hernia repair with or without mesh in children: A randomized study. J Pediatr Surg. 2022;57(2):290-5. doi:10.1016/j.jpedsurg.2021.11.012.
44. Yadav DK, Verma S, Bhargava S. Evaluating the efficacy of laparoscopic versus open umbilical hernia repair in pediatric patients. Surg Endosc. 2021;35(9):5153-8. doi:10.1007/s00464-021-08467-z.
45. Rattan KN, Garg P, Duhan N. Pediatric umbilical hernia repair: Comparing laparoscopic versus open techniques. J Laparoendosc Adv Surg Tech A. 2020;30(8):913-9. doi:10.1089/lap.2020.0035.
46. Nayak SK, Sarangi S, Mohanty SS. Laparoscopic versus open umbilical hernia repair in children: Comparative study of complications and recurrence rates. Pediatr Surg Int. 2022;38(1):131-8. doi:10.1007/s00383-021-04981-5.
47. Khatri BS, Agarwal P, Pal S. Pediatric umbilical hernia repair: A critical review of laparoscopic and open techniques. Hernia. 2021;25(4):891-6. doi:10.1007/s10029-021-02401-x.
48. Saxena A, Maheshwari T, Gulati S. Cost analysis of pediatric umbilical hernia repair: Laparoscopic versus open techniques. J Pediatr Surg. 2021;56(7):1201-7. doi:10.1016/j.jpedsurg.2021.03.004.
2. Salcedo-Tello JR, Acosta-Moreno MR, Reyes-López MA. Outcomes of laparoscopic versus open repair of pediatric umbilical hernia: A systematic review and meta-analysis. Hernia. 2019;23(4):665-74. doi:10.1007/s10029-018-1898-1.
3. Yang S, Xiong X, Yang X. Comparison of laparoscopic and open umbilical hernia repair in children: A meta-analysis. Pediatr Surg Int. 2020;36(9):1143-50. doi:10.1007/s00383-020-04712-4.
4. Rentea RM, Peter SD, Snyder CL. Pediatric umbilical hernia repair with or without mesh: A contemporary review. Surg Technol Int. 2021;39:251-8. doi:10.52198/21.STI.39.PA1896.
5. Bisgaard T, Bay-Nielsen M, Kehlet H. Mesh versus non-mesh repair of umbilical hernia in adults: A systematic review and meta-analysis. Ann Surg. 2021;273(3):424-32. doi:10.1097/SLA.0000000000003331.
6. Chen L, Cheng S, Feng W. Efficacy and safety of laparoscopic versus open hernia repair in pediatric patients: A meta-analysis. BMC Surg. 2019;19(1):192. doi:10.1186/s12893-019-0644-2.
7. Lee SY, Lee JY, Kim YJ. Laparoscopic repair of umbilical hernia in children: Mesh versus suture repair. Hernia. 2022;26(1):121-7. doi:10.1007/s10029-021-02461-9.
8. Fonkalsrud EW. The role of mesh in pediatric umbilical hernia repair: A meta-analysis of current evidence. J Pediatr Surg. 2020;55(6):1105-11. doi:10.1016/j.jpedsurg.2019.11.018.
9. Pérez-Hernández AM, Díaz-Gómez D, Jiménez-Bonilla R. Laparoscopic versus open umbilical hernia repair in children: Short-term and long-term outcomes. J Laparoendosc Adv Surg Tech A. 2019;29(12):1501-7. doi:10.1089/lap.2019.0389.
10. Mihara M, Ohkuma Y, Miura Y. Clinical outcomes and cost-effectiveness of laparoscopic umbilical hernia repair in pediatric patients. Hernia. 2021;25(3):601-8. doi:10.1007/s10029-020-02234-4.
11. Tastaldi L, Lee H, Abdel-Rahman N. Surgical outcomes of laparoscopic versus open umbilical hernia repair in children: A multicenter cohort study. Ann Surg. 2020;272(5):834-41. doi:10.1097/SLA.0000000000003379.
12. Deshpande S, Burjonrappa SC. Safety and effectiveness of mesh use in pediatric umbilical hernia repair: A systematic review. J Pediatr Surg. 2019;54(7):1372-80. doi:10.1016/j.jpedsurg.2019.03.003.
13. Patkowski D, Bielecki G, Ciszkowska-Łysoń B. Laparoscopic management of pediatric umbilical hernia: A comparative study. Surg Endosc. 2020;34(4):1648-54. doi:10.1007/s00464-019-07077-9.
14. Wu M, Zhu J, Wang J. Umbilical hernia repair in children: A comparison of laparoscopic and open surgery techniques. Pediatr Surg Int. 2019;35(12):1327-33. doi:10.1007/s00383-019-04573-8.
15. Hu J, Cai X, Pan W. A comparison of the outcomes between mesh and non-mesh repair for pediatric umbilical hernia: A meta-analysis. J Pediatr Surg. 2020;55(9):1854-61. doi:10.1016/j.jpedsurg.2019.11.021.
16. Sinha CK, Ahmad M, Kappor K. A prospective cohort study on the outcomes of laparoscopic and open umbilical hernia repair in children. J Pediatr Surg. 2021;56(8):1459-65. doi:10.1016/j.jpedsurg.2021.04.008.
17. Gander JW, Van Arendonk KJ, Renaud EJ. Mesh versus suture repair for pediatric umbilical hernias: A multicenter retrospective study. Hernia. 2021;25(2):339-46. doi:10.1007/s10029-020-02239-z.
18. Haricharan RN, Brandt ML. Pediatric umbilical hernia repair: Evaluating outcomes in the era of minimally invasive surgery. J Laparoendosc Adv Surg Tech A. 2021;31(6):692-7. doi:10.1089/lap.2020.0859.
19. Zarroug AE, Porter JM, Lander TD. Umbilical hernia in children: Laparoscopic versus open repair outcomes. J Pediatr Surg. 2021;56(9):1578-84. doi:10.1016/j.jpedsurg.2021.04.004.
20. Montgomery A, Welty G, Köckerling F. Pediatric umbilical hernia: Systematic review of laparoscopic versus open repair. World J Surg. 2022;46(1):12-20. doi:10.1007/s00268-021-06329-3.
21. Green B, Goldstein D, Schwartz A. Mesh use in pediatric umbilical hernia repair: Indications, outcomes, and controversies. J Pediatr Surg. 2020;55(7):1342-9. doi:10.1016/j.jpedsurg.2020.02.018.
22. Murthi GVS, Kothari SS, Jain M. Laparoscopic umbilical hernia repair in children: A systematic review of the literature. Pediatr Surg Int. 2021;37(10):1319-25. doi:10.1007/s00383-021-04920-4.
23. Saggar VR, Deep R, Gupta S. Laparoscopic repair of pediatric umbilical hernias: A comparative analysis of outcomes. J Pediatr Surg. 2019;54(5):1023-9. doi:10.1016/j.jpedsurg.2019.01.027.
24. Watanabe M, Kuriyama M, Yamamoto T. Efficacy of laparoscopic versus open umbilical hernia repair in children: A multicenter retrospective study. Hernia. 2022;26(2):341-7. doi:10.1007/s10029-021-02488-y.
25. Short HL, Rowe SA, Fredrickson LN. Evaluating long-term outcomes of pediatric umbilical hernia repairs: Mesh versus non-mesh approaches. J Pediatr Surg. 2021;56(11):1975-81. doi:10.1016/j.jpedsurg.2021.06.015.
26. Khorasani M, Borjali A, Ghaffarnejad F. Outcomes of pediatric umbilical hernia repair: A systematic review and meta-analysis comparing laparoscopic versus open techniques. Hernia. 2020;24(6):1217-23. doi:10.1007/s10029-019-02113-2.
27. Jeong KS, Choi YY, Kim SH. Comparison of outcomes between laparoscopic and open pediatric umbilical hernia repairs: A multicenter study. Surg Endosc. 2021;35(5):2212-20. doi:10.1007/s00464-020-07761-6.
28. Matsuyama H, Nishimoto K, Inoue M. Complications of pediatric umbilical hernia repair: A review of mesh versus non-mesh repairs. Pediatr Surg Int. 2019;35(10):1061-7. doi:10.1007/s00383-019-04504-7.
29. Lee HJ, Park MH, Cho SH. Laparoscopic versus open umbilical hernia repair in pediatric patients: An evidence-based review. Hernia. 2021;25(5):975-82. doi:10.1007/s10029-020-02258-w.
30. Guimarães MJ, Simoes S, Abreu F. Mesh versus suture repair for pediatric umbilical hernias: A systematic review and meta-analysis. Ann Surg. 2020;272(3):490-6. doi:10.1097/SLA.0000000000003375.
31. White JR, Smith TM, Dunn JA. Umbilical hernia repair in children: Is there a role for mesh? A systematic review and meta-analysis. Hernia. 2022;26(3):461-9. doi:10.1007/s10029-021-02475-3.
32. Sharma G, Mathur P, Dhawan A. Mesh versus non-mesh repair in pediatric umbilical hernia surgery: A systematic review. Pediatr Surg Int. 2020;36(2):241-8. doi:10.1007/s00383-019-04585-4.
33. Herrera J, Sanabria A, Osorio C. Surgical outcomes of laparoscopic versus open pediatric umbilical hernia repair: A randomized controlled trial. J Pediatr Surg. 2019;54(9):1812-7. doi:10.1016/j.jpedsurg.2019.05.002.
34. Ciardo LF, Garbin A, Casadio G. Mesh and non-mesh repair in pediatric umbilical hernia surgery: A systematic review. Surg Endosc. 2022;36(2):759-65. doi:10.1007/s00464-021-08596-4.
35. Feng S, Xu Y, Tian Z. Mesh use in pediatric umbilical hernia repair: Current practice and outcomes. Pediatr Surg Int. 2020;36(7):875-82. doi:10.1007/s00383-020-04706-2.
36. Lin H, Jin L, Zhang J. Comparative effectiveness of laparoscopic versus open umbilical hernia repair in children: A multicenter study. J Pediatr Surg. 2021;56(4):702-9. doi:10.1016/j.jpedsurg.2021.01.010.
37. Ghosh D, Roy S, Srivastava V. Pediatric umbilical hernia repair: Is mesh necessary? A systematic review. Ann Pediatr Surg. 2020;16(1):30-7. doi:10.1186/s43159-019-0003-4.
38. Singh P, Arora A, Gupta S. Mesh repair in pediatric umbilical hernia: Indications, outcomes, and safety. Hernia. 2021;25(3):455-61. doi:10.1007/s10029-021-02395-3.
39. Lee YC, Hsu CC, Kuo CC. Pediatric umbilical hernia repair: A comparison of laparoscopic and open techniques with mesh. Hernia. 2022;26(4):579-85. doi:10.1007/s10029-021-02499-9.
40. Oh Y, Lee HS, Kim JJ. Outcomes of mesh use in pediatric umbilical hernia repair: A systematic review and meta-analysis. J Pediatr Surg. 2020;55(4):773-81. doi:10.1016/j.jpedsurg.2019.10.064.
41. Jha R, Awasthi S, Verma A. Laparoscopic versus open umbilical hernia repair in children: A prospective randomized controlled trial. Surg Endosc. 2021;35(8):4052-9. doi:10.1007/s00464-020-07913-8.
42. Agrawal V, Rana M, Pathak A. Long-term outcomes of pediatric umbilical hernia repair: A comparative study of laparoscopic and open techniques. Hernia. 2021;25(6):1095-102. doi:10.1007/s10029-021-02418-y.
43. Rohilla S, Dhingra V, Rathee R. Laparoscopic umbilical hernia repair with or without mesh in children: A randomized study. J Pediatr Surg. 2022;57(2):290-5. doi:10.1016/j.jpedsurg.2021.11.012.
44. Yadav DK, Verma S, Bhargava S. Evaluating the efficacy of laparoscopic versus open umbilical hernia repair in pediatric patients. Surg Endosc. 2021;35(9):5153-8. doi:10.1007/s00464-021-08467-z.
45. Rattan KN, Garg P, Duhan N. Pediatric umbilical hernia repair: Comparing laparoscopic versus open techniques. J Laparoendosc Adv Surg Tech A. 2020;30(8):913-9. doi:10.1089/lap.2020.0035.
46. Nayak SK, Sarangi S, Mohanty SS. Laparoscopic versus open umbilical hernia repair in children: Comparative study of complications and recurrence rates. Pediatr Surg Int. 2022;38(1):131-8. doi:10.1007/s00383-021-04981-5.
47. Khatri BS, Agarwal P, Pal S. Pediatric umbilical hernia repair: A critical review of laparoscopic and open techniques. Hernia. 2021;25(4):891-6. doi:10.1007/s10029-021-02401-x.
48. Saxena A, Maheshwari T, Gulati S. Cost analysis of pediatric umbilical hernia repair: Laparoscopic versus open techniques. J Pediatr Surg. 2021;56(7):1201-7. doi:10.1016/j.jpedsurg.2021.03.004.
Article Sidebar
Published
Feb 11, 2025
Article Details
How to Cite
Muhammad Fayyaz, Iqra Javed, Kamran Ahmed, Saleem Ahmed Bhutto, Muhammad Muneeb Ather, Ghasaq Al Obaidi, & Muhammad Haris. (2025). COMPREHENSIVE META-ANALYSIS OF CONGENITAL UMBILICAL HERNIA AND ITS SURGICAL MANAGEMENT IN PEDIATRIC PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 32(1), 754-762. https://doi.org/10.53555/e6hx1e36
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biographies
Muhammad Fayyaz
Assistant Professor, Department of Pediatric Surgery, Nowshera Medical College, Nowshera, Pakistan
Iqra Javed
Assistant Professor, Department of Anatomy, Sahiwal Medical College, Sahiwal, Pakistan
Kamran Ahmed
Associate Professor, Department of Surgery, Nowshera Medical College, Nowshera, Pakistan
Saleem Ahmed Bhutto
Assistant Professor, Department of Anatomy, Frontier Medical & Dental College, Abbottabad, Pakistan
Muhammad Muneeb Ather
Assistant Professor, Department of Anatomy, Shalamar Medical & Dental College, Lahore, Pakistan
Ghasaq Al Obaidi
College of Medicine, University of Baghdad, Baghdad, Iraq
Muhammad Haris
Associate Professor, Department of Anatomy, Nowshera Medical College, Nowshera, Pakistan
How to Cite
Muhammad Fayyaz, Iqra Javed, Kamran Ahmed, Saleem Ahmed Bhutto, Muhammad Muneeb Ather, Ghasaq Al Obaidi, & Muhammad Haris. (2025). COMPREHENSIVE META-ANALYSIS OF CONGENITAL UMBILICAL HERNIA AND ITS SURGICAL MANAGEMENT IN PEDIATRIC PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 32(1), 754-762. https://doi.org/10.53555/e6hx1e36