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Independent risk factors for contralateral patent processus vaginalis undetected by pre-operative ultrasonography in boys with unilateral inguinal hernia

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Abstract

Purpose

Many trials have been done to make sure probability of metachronous contralateral side hernia (MCH) and contralateral patent processus vaginalis (CPPV). But the necessity of contralateral side exploration is still on debate. The aim is to investigate the risk factors for the consideration of contralateral examination on operation.

Materials and methods

The study was designed as retrospectively. Patients with unilateral inguinal hernia from January 2010 to May 2015 were enrolled. Pre-operative ultrasonography was done in all patients. Patients with obvious contralateral side hernia on pre-operative US were excluded. The presence of CPPV was evaluated by transinguinal laparoscopy during the operation.

Results

In univariate analysis, hernial sac size only shows difference (P value: 0.001). The others, location of the hernia, age at surgery, gestational age (preterm), low birth weight and parent’s age, did not show statistically significant differences. Multivariate analysis also demonstrates CPPV is more common in patients with large hernial sac (Odds ratio: 2.727, 95% confidence interval 1.495–4.974, P value: 0.001).

Conclusion

We propose that surgeons should consider contralateral evaluation during operation in case with large ipsilateral hernial sac, although CPPV was not detected by pre-operative US.

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References

  1. Mollen KP, Kane TD (2007) Inguinal hernia: what we have learned from laparoscopic evaluation of the contralateral side. Curr Opin Pediatr 19(3):344–348

    Article  PubMed  Google Scholar 

  2. Miltenburg DM et al (1997) Meta-analysis of the risk of metachronous hernia in infants and children. Am J Surg 174(6):741–744

    Article  CAS  PubMed  Google Scholar 

  3. Miltenburg DM et al (1998) Laparoscopic evaluation of the pediatric inguinal hernia–a meta-analysis. J Pediatr Surg 33(6):874–879

    Article  CAS  PubMed  Google Scholar 

  4. Rothenberg RE, Barnett T (1955) Bilateral herniotomy in infants and children. Surgery 37(6):947–950

    CAS  PubMed  Google Scholar 

  5. Kokorowski PJ et al (2014) Evaluation of the contralateral inguinal ring in clinically unilateral inguinal hernia: a systematic review and meta-analysis. Hernia 18(3):311–324

    Article  CAS  PubMed  Google Scholar 

  6. Maddox MM, Smith DP (2008) A long-term prospective analysis of pediatric unilateral inguinal hernias: should laparoscopy or anything else influence the management of the contralateral side? J Pediatr Urol 4(2):141–145

    Article  CAS  PubMed  Google Scholar 

  7. Lotan G et al (2004) Transinguinal laparoscopic examination: an end to the controversy on repair of inguinal hernia in children. Isr Med Assoc J 6(6):339–341

    PubMed  Google Scholar 

  8. Lazar DA et al (2011) Transinguinal laparoscopic exploration for identification of contralateral inguinal hernias in pediatric patients. J Pediatr Surg 46(12):2349–2352

    Article  PubMed  Google Scholar 

  9. Valusek PA et al (2006) Laparoscopic evaluation for contralateral patent processus vaginalis in children with unilateral inguinal hernia. J Laparoendosc Adv Surg Tech A 16(6):650–653

    Article  PubMed  Google Scholar 

  10. Zhong H, Wang F (2014) Contralateral metachronous hernia following negative laparoscopic evaluation for contralateral patent processus vaginalis: a meta-analysis. J Laparoendosc Adv Surg Tech A 24(2):111–116

    Article  PubMed  Google Scholar 

  11. Hall NJ et al (2012) Age-related probability of contralateral processus vaginalis patency in children with unilateral inguinal hernia. Pediatr Surg Int 28(11):1085–1088

    Article  PubMed  Google Scholar 

  12. Rowe M, Copelson L, Clatworthy HW (1969) The patent processus vaginalis and the inguinal hernia. J Pediatr Surg 4:102–107

    Article  CAS  PubMed  Google Scholar 

  13. Sumida W et al (2016) Incidence of contralateral patent processus vaginalis in relation to age at laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia. Surg Today 46(4):466–470

    Article  PubMed  Google Scholar 

  14. Vogels HD et al (2009) The degree to which the size and side of an inguinal hernia is predictive of a hernia on the other side. Pediatr Surg Int 25(3):229–233

    Article  CAS  PubMed  Google Scholar 

  15. Lee DG et al (2015) Risk factors for contralateral patent processus vaginalis determined by transinguinal laparoscopic examination. Exp Ther Med 9(2):421–424

    Article  PubMed  Google Scholar 

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Correspondence to Seung Hyo Woo.

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None declared.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was not obtained because this study was done retrospectively.

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Jo, Hu., Yoo, D.S., Park, J. et al. Independent risk factors for contralateral patent processus vaginalis undetected by pre-operative ultrasonography in boys with unilateral inguinal hernia. Pediatr Surg Int 35, 591–595 (2019). https://doi.org/10.1007/s00383-019-04444-x

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  • DOI: https://doi.org/10.1007/s00383-019-04444-x

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