Systematic review for paediatric metachronous contralateral inguinal hernia: a decreasing concern

Nataraja, Ramesh M.; Mahomed, Anies

doi:10.1007/s00383-011-2919-z

Cited by 45 publications

(59 citation statements)

References 59 publications

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“…In 1955, Rothenberg and Barnett recommended prophylactic contralateral exploration in all children (2). However, a meta-analysis revealed that the risk of contralateral hernia is only 5.76% (3). In addition, a previous study by the present authors found that the incidence was 9.5% (4).…”

Section: Introductionmentioning

confidence: 70%

1620 Risk Factors for Contralateral Patent Processus Vaginalis Determined by Transinguinal Laparoscopic Examination

Lee¹,

Lee²,

Park³

et al. 2012

Journal of Urology

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Abstract. Concurrent contralateral inguinal exploration in children with unilateral hernia or hydrocele is a subject of debate. The aim of the present study was to investigate the incidence of contralateral patent processus vaginalis (CPPV) using transinguinal laparoscopy (inguinoscopy). In addition, the risk factors of CPPV were evaluated in order to facilitate the selection of appropriate candidates for contralateral examination. A total of 119 patients who presented with unilateral hydrocele, inguinal hernia or cryptorchidism between 2001 and 2008 underwent inguinoscopy during the ipsilateral surgery. All data were collected prospectively. The incidence of CPPV was investigated and the risk factors affecting the presence of CPPV were analyzed. Among these patients, 29 individuals (24.4%) had CPPV confirmed by inguinoscopy. No surgical complications were observed during the inguinoscopy. Cases with suspicious ultrasound findings were at a higher risk of CPPV than cases with normal findings (odds ratio, 13.800; P=0.004). A history of contralateral disease was also found to be a significant risk factor (odds ratio, 4.008; P=0.019). The present study identified that the significant risk factors for CPPV were suspicious findings on ultrasound examination and a history of contralateral disease. Therefore, it is concluded that performing inguinoscopy in children with these risk factors is beneficial. IntroductionConcurrent contralateral inguinal exploration in children with unilateral hernia or hydrocele is a subject of considerable debate. In 1952, Duckett reported that a contralateral hernia was present in as many as 30% of children presenting with unilateral hernias (1). In 1955, Rothenberg and Barnett recommended prophylactic contralateral exploration in all children (2). However, a meta-analysis revealed that the risk of contralateral hernia is only 5.76% (3). In addition, a previous study by the present authors found that the incidence was 9.5% (4). Therefore, it is widely considered that contralateral groin exploration is not justified in children with unilateral disease due to the low incidence of contralateral hernia and the potential for operative complications.To avoid unnecessary contralateral inguinal exploration, several preoperative diagnostic tools, such as physical examination and herniography, have been used. However, these tests have low accuracy rates and high false positive rates (5). In 1992, laparoscopy was introduced as a tool for the diagnosis of contralateral patent processus vaginalis (CPPV) (6). If CPPV is observed laparoscopically, the PPV can be repaired through a groin incision or laparoscopy. Transinguinal laparoscopy (inguinoscopy) has been shown to be a safe, accurate and effective method of evaluating the contralateral side (7). Regardless of the convenience and accuracy of laparoscopy, performing laparoscopy for all patients with unilateral hernia or hydrocele is unreasonable.The aim of the present study was to investigate the incidence of CPPV using inguinoscopy. In order to aid ...

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Section: Introductionmentioning

confidence: 70%

1620 Risk Factors for Contralateral Patent Processus Vaginalis Determined by Transinguinal Laparoscopic Examination

Lee¹,

Lee²,

Park³

et al. 2012

Journal of Urology

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“…However, none of these studies have evaluated the association of the groin hernia subtypes bilaterally. The risk of developing bilateral hernias has more extensively been examined in children, and reported risk factors are birth prematurity and having a primary left sided inguinal hernia [27][28][29]. The limitations of this study include that only groin hernias requiring surgical interventions were evaluated.…”

Section: Discussionmentioning

confidence: 99%

Groin hernia subtypes are associated in patients with bilateral hernias: a 14-year nationwide epidemiologic study

et al. 2014

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“…Otherwise, in pediatrics survey and according to Nataraja and Mahomed[5] and Ron et al .,[6] the hernia occurrence in children is closely related to age and the risk is particularly increased in children under 2 years of age.…”

Section: Discussionmentioning

confidence: 99%

“…[6] as well as with Nataraja and Mahomed[5] Steven et al . [16] found a moderate rate of metachronous hernia (14%).…”

Section: Discussionmentioning

confidence: 99%

Male gender and prematurity are risk factors for incarceration in pediatric inguinal hernia: A study of 922 children

Ksia

Braiki

Ouaghnan

et al. 2017

J Indian Assoc Pediatr Surg

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Objectives:The purpose of this study was to document clinical features of inguinal hernia (IH) in the pediatric population. It provides data to evaluate associated risk factors of incarcerated hernia, its recurrence as well as the occurrence of contralateral metachronous hernia.Materials and Methods:We report a retrospective analytic study including 922 children presenting with IH and operated from 2010 to 2013 in our pediatric surgery department.Results:We managed 143 girls (16%) and 779 boys (84%). The mean age was 2 years; the right side was predominantly affected (66.8%, n = 616). Incarcerated hernia was documented in 16% of cases with an incidence of 33% in neonates. The incarceration occurrence was 15.5% in males versus 2.09% in females. The surgical repair was done according to Forgue technique. Postoperatively, four cases of hernia recurrence were documented, and contralateral metachronous hernia was reported in 33 children with 7.7% females versus 2.8% males. Forty-five percent of them were infants. The mean follow-up period was 4 years. We think that incarceration can be related to several risk factors such as feminine gender, prematurity, and the initial left side surgical repair of the hernia.Conclusion:IH occurs mainly in male infants. Prematurity and male gender were identified as risk factors of incarceration. Contralateral metachronous hernia was reported, especially in female infants and after a left side surgical repair of the hernia.

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Systematic review for paediatric metachronous contralateral inguinal hernia: a decreasing concern

Cited by 45 publications

References 59 publications

1620 Risk Factors for Contralateral Patent Processus Vaginalis Determined by Transinguinal Laparoscopic Examination

1620 Risk Factors for Contralateral Patent Processus Vaginalis Determined by Transinguinal Laparoscopic Examination

Groin hernia subtypes are associated in patients with bilateral hernias: a 14-year nationwide epidemiologic study

Male gender and prematurity are risk factors for incarceration in pediatric inguinal hernia: A study of 922 children

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