Incidence of pediatric metachronous contralateral inguinal hernia in children aged ≥1 year

Jin-hu, Wang; Zhang, Wei; Tou, Jinfa; Huang, Shoujiang; Liu, Wei-Guang; Xiong, Qi; Zhao, Zhengyan

doi:10.1007/s12519-012-0367-z

Cited by 11 publications

(4 citation statements)

References 23 publications

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“…The incidence of CPPV at laparoscopy in the present study was 51·5 per cent, higher than in previous reports. The incidence of MIH after open hernia repair was much lower than in other reports, but consistent with the authors' previous study and one by Maddox and Smith. The low rate of MIH may be related to (young) age at surgery, short postoperative follow‐up, population flow and/or those lost to follow‐up.…”

Section: Discussionsupporting

confidence: 87%

Potential value of routine contralateral patent processus vaginalis repair in children with unilateral inguinal hernia

Zhao¹,

Chen²,

Lin

et al. 2016

British Journal of Surgery

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Section: Discussionsupporting

confidence: 87%

Potential value of routine contralateral patent processus vaginalis repair in children with unilateral inguinal hernia

Zhao¹,

Chen²,

Lin

et al. 2016

British Journal of Surgery

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“…The controversies based on certain studies are summarized as follows: 1) 38% -100% of children with a unilateral hernia have a contralateral PPV (Patent Processus Vaginalis) [72] [73], 2) 60% of children with a unilateral hernia have a contralateral PPV at 2 months of age, 40% by 2 years, and half of these children may develop an inguinal hernia [74], 3) there is a risk of about 10% to develop a hernia if the initial hernia is on the left, and 4) contralateral exploration might prevent a second operation that means higher costs, and distress of the child and his parents [75]. However, Tackett et al [76] in a prospective study of 656 children reported a metachronous hernia rate of 8.8%, and Wang et al [77] reported an incidence of 5.2% in 2129 children aged ≥1 year. Furthermore, Ron et al [78], reported that 14 explorations are needed to prevent one metachronous IH, and in the case of a left sided IH, 10 explorations are required to prevent one.…”

Section: Contralateral Explorationmentioning

confidence: 99%

Current Trends in the Management of Inguinal Hernia in Children

Zavras¹,

Christou²,

Misiakos³

et al. 2014

IJCM

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Inguinal hernia repairs in one of the most common surgical procedures in the pediatric population. Its diagnosis is made easily and the repair is usually performed by open surgery and with low complications rates. However, a substantial number of topics concerning anesthetic management, the precise time of operation especially in premature and high-risk infants, and the need of contralateral exploration have not yet been resolved. Recently, the introduction of laparoscopic repair seems to play a significant role regarding the safety, the examination and possible simultaneously repair of the contralateral groin, and the better cosmetic results. In this review, the current trends of the above mentioned topics will be discussed.

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“…According to our previous study, MIH developed mostly in boys under 2 years old and within 2 years after the initial herniorrhaphy ( 2 ). Therefore, this study, we focused on boys under 2 years old and set the follow-up period to 2 years.…”

Section: Discussionmentioning

confidence: 93%

Pre-operative Spermatic Cord Ultrasonography Helps to Reduce the Incidence of Metachronous Inguinal Hernia in Boys

Huang

Yang

et al. 2018

Front. Pediatr.

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Background/purpose: Thickening of the spermatic cord is a clinical sign of an inguinal hernia. We therefore tested whether pre-operative spermatic cord ultrasonography could reduce the incidence of metachronous inguinal hernia (MIH).Methods: Boys under 2 years old with an initial unilateral inguinal hernia were enrolled in this study. In whom the width of the asymptomatic-sided spermatic cord was ≥0.5 cm, these patients underwent contralateral groin exploration. Age at initial operation, weight, initial operation side, the sonographic width of the spermatic cord, the operative findings and presence of MIH were recorded, and the relationship among them was studied. Boys in the US group underwent an open herniorrhaphy with pre-operative ultrasound examination; the non-US group included boys who did not undergo a pre-operative ultrasound examination. A receiver operator curve (ROC) analysis was performed to evaluated predictive value of the sonographic width of the spermatic cord for contralateral hernia.Results: A total of 24 months' follow-up data were obtained from 1,793 boys (US group 1,162, non-US group 631). In the US group, the width of the hernia-sided spermatic cord (0.75 ± 0.18 cm) was larger than the normal side (0.37 ± 0.05 cm, P < 0.001). And the width of normal side spermatic cord had no significant difference between the groups regarding other factors such as age and weight. In whom the width of the asymptomatic-sided spermatic cord was ≥0.5 cm, the corresponding incidence of CIH was 86.4% (57/66). The width of the spermatic cord predicted the presence of contralateral hernia with ROC area under the curve = 0.943 (95% CI = 0.919–0.966). The total incidence of MIH was 4.1% (74/1793). The incidence of MIH in the US group was 2.2% (25/1162) much lower than 7.8% (49/631) in the non-US group (P < 0.001). If the width of the asymptomatic-sided spermatic cord was 0.5 cm and 0.54 cm, the corresponding sensitivity was 0.682 and 0.294, respectively, the corresponding specificity was 0.991 and 1.000, respectively.Conclusion: If the width of the asymptomatic-sided spermatic cord of boys with initial unilateral inguinal hernia sonographic width was ≥0.5 cm, contralateral groin exploration was recommended, and it help to reduce the incidence of MIH.

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Incidence of pediatric metachronous contralateral inguinal hernia in children aged ≥1 year

Cited by 11 publications

References 23 publications

Potential value of routine contralateral patent processus vaginalis repair in children with unilateral inguinal hernia

Potential value of routine contralateral patent processus vaginalis repair in children with unilateral inguinal hernia

Current Trends in the Management of Inguinal Hernia in Children

Pre-operative Spermatic Cord Ultrasonography Helps to Reduce the Incidence of Metachronous Inguinal Hernia in Boys

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