Is contralateral inguinal exploration necessary in preterm girls undergoing inguinal hernia repair during the first months of life?

Demouron, M.; Delforge, Xavier; Buisson, Philippe; Hamzy, Mounia; Klein, Céline; Haraux, Élodie

doi:10.1007/s00383-018-4334-1

Cited by 2 publications

(2 citation statements)

References 25 publications

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“…The administration of contralateral PPV remains controversial [30], and there is also a concern for overtreatment [31]. Despite the relatively high prevalence of contralateral PPV in unilateral inguinal hernia, some pediatric surgeons argue that a PPV at exploration may not necessarily mean possible development of a hernia at a later age [32]. Meanwhile, the follow-up period has been very limited to the age period in most patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of laparoscope-assisted single-needle laparoscopic percutaneous extraperitoneal closure versus open repair for pediatric inguinal hernia

Xing

et al. 2022

BMC Surg

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Background Laparoscopic-assisted repairs for pediatric inguinal hernia have gained gradual acceptance over the past decade. However, consensus about the optimal management is still lacking. The aim of this study is to compare outcomes of a modified laparoscope-assisted single-needle laparoscopic percutaneous extraperitoneal closure (LPEC) versus open repair of pediatric hernias/hydrocele in a single institution. Materials and methods We retrospectively reviewed the medical data of children who underwent laparoscope-assisted single-needle LPEC and open repair (OR) for inguinal hernia from 2014 to 2019. Data collection included demographics, laterality of hernia, surgical time and time to follow-up. We also reviewed and analyzed the evidence of recurrence, the incidence of metachronous contralateral inguinal hernia (MCIH), and other complications. Results In our cohort, 961 patients in the OR group and 1098 patients in the LPEC group were analyzed retrospectively. Mean operative time was significantly shorter in the LPEC group (22.3 ± 3.5 min) than in the OR group (27.8 ± 5.9 min) for bilateral hernia repair (p < 0.001). Postoperative recurrence was 1.3% (13/1035) in the OR group and 0.5% (6/1182) in the LPEC group (p = 0.056). Iatrogenic cryptorchidism occurred statistically more frequently in the OR group than in the LPEC group (0.4% vs. 0%, p = 0.013). In addition, the incidence of MCIH was 3.7% (33/887) in the OR group and 0.3% (3/1014) in the LPEC group (p < 0.01). Conclusion Comparing to open technique, laparoscope-assisted single-needle LPEC provides a simple and effective option for pediatric inguinal hernia/hydrocele repair with excellent outcomes, a low incidence of recurrence, and reduced MCIH.

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Section: Discussionmentioning

confidence: 99%

Comparison of laparoscope-assisted single-needle laparoscopic percutaneous extraperitoneal closure versus open repair for pediatric inguinal hernia

Xing

et al. 2022

BMC Surg

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“…We recom mend that VLBW infants with primary right-sided hernia should be followed up carefully because of their risk of developing metachronous hernia. Demouron et al 26) reported that in female preterm infants, metachronous hernia was more common in those with primary right-sided hernias, perhaps because right-sided inguinal hernias are more common than left-sided in guinal hernias. Metachronous hernia was more frequent in primary left-sided hernias in another study 27) .…”

Section: Discussionmentioning

confidence: 99%

Inguinal Hernia in Preterm Infants: Optimal Timing of Herniorrhaphy to Prevent Preoperative Incarceration and Postoperative Apnea

Shin

Jeon

2020

Neonatal Med

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Purpose: The objective of this study was to determine the optimal timing of inguinal herniorrhaphy in preterm infants to reduce the risks of preoperative incarceration and postoperative complications. Methods: Preterm infants with gestational age (GA) of <37 weeks who had ingui nal herniorrhaphy before the age of 6 months were enrolled. Early repair was defined as undergoing herniorrhaphy before discharge from the neonatal intensive care unit (NICU), and late repair was defined as undergoing herniorrhaphy as an outpatient after discharge from the NICU. Results: The incidence rates of preoperative incarceration and recurrence were not significantly different between the two groups. Postoperative apnea and mechanical ventilation were more frequent in the early-repair group than in the late-repair group. Postoperative apnea was more frequent in the early-repair group after adjustments for GA and birth weight. However, no significant difference in postoperative mechanical ventilation was found between the two groups after adjustments for GA and birth weight. The incidence of postoperative apnea was associated with small weight at repair, early repair, general anesthesia, younger GA, small weight at birth, and bronchopul monary dysplasia. Contralateral metachronous hernia was most frequent in infants with small weight at repair, early repair, very low birth weight (VLBW), male sex, and right-sided hernia. Conclusion: Late repair was safe and did not increase the risk of incarceration or recurrence, but decreased the risks of postoperative apnea and metachronous hernia. Regional anesthesia could reduce the risk of postoperative apnea. Male infants born with VLBWs and right-sided hernia should be followed up carefully for metachronous hernia.

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Is contralateral inguinal exploration necessary in preterm girls undergoing inguinal hernia repair during the first months of life?

Cited by 2 publications

References 25 publications

Comparison of laparoscope-assisted single-needle laparoscopic percutaneous extraperitoneal closure versus open repair for pediatric inguinal hernia

Comparison of laparoscope-assisted single-needle laparoscopic percutaneous extraperitoneal closure versus open repair for pediatric inguinal hernia

Inguinal Hernia in Preterm Infants: Optimal Timing of Herniorrhaphy to Prevent Preoperative Incarceration and Postoperative Apnea

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