To explore the establishment of an individualized prediction model for the risk of recurrence after laparoscopic high ligation of indirect hernia sac in children.

The clinical data of 194 children with indirect inguinal hernia who underwent laparoscopic high ligation of hernia sac in the First Affiliated Hospital of Xinjiang Medical University from October 2017 to October 2019 were collected. The children were divided into recurrence group (31 cases) and no recurrence group (163 cases) based on whether they had recurrence. All children in the recurrence group were treated with a second open high ligation of hernia sac. The risk factors of postoperative recurrence were analyzed using univariate analysis and multivariate logistic regression, and the related nomogram model was established.

Univariate analysis showed that there was no significant difference between the two groups in sex, course of disease, occult hernia, incarcerated hernia, hernia ring adhesion, location of disease and hernia sac size (P>0.05). There were significant differences in age, childhood obesity, inner ring size and ligation suture type between the two groups (P<0.05). Multivariate analysis showed that age ≥6 years old, childhood obesity, internal ring size ≥3 cm and absorbable suture ligation were independent risk factors for recurrence after laparoscopic high ligation of indirect hernia sac in children (P<0.05). The model verification results show that the C-index is 0.744, the correction curve is close to the ideal curve, indicating a good prediction accuracy. The area under the ROC curve is 0.760 (95% CI: 0.715-0.803), indicating good discrimination.

Attention should be paid to children with indirect inguinal hernia who aged ≥6 years, with obesity, whose inner ring size is ≥3 cm and who had absorbable suture ligation. They should be vigilant about their recurrence after laparoscopic high ligation of hernia sac. The nomogram model can effectively predict the risk of recurrence after laparoscopic high ligation of indirect hernia sac in children.