Contralateral exploration is not mandatory in unilateral inguinal hernia in children: a prospective 6-year study.
Contralateral exploration (CE) in children with a unilateral inguinal hernia (IH) is still controversial. To define the necessity of CE in unilaterally-presenting IH, all patients who had been operated upon unilaterally in a 6-year period and were followed for 4-10 years had annual evaluations for a contra-lateral IH. Comparison of the frequency of different variables was done by chi-square test. Of 650 patients aged 1 month-12 years, 521 (3.6%) developed a contralateral IH. There was no significant difference in occurrence in the different sex and age groups. There was a significant difference in the side of presentation: patients who presented with a left-sided hernia had a greater chance of developing a contralateral IH (P = 0.006). The finding of a patent processus vaginalis (PPV) in the literature is usually present in over 35% of cases, while the occurrence of a contralateral hernia is usually seen in less than 15% of cases. In our study this rate was also very low (3.6%). Therefore, it seems that most PPVs will close or remain asymptomatic and only a few will lead to IHs, so that routine CE does not seem justified.
Nassiri
S Javad
SJ
Aliasghar Children's Hospital, Department of Pediatric Surgery, Iran University of Medical Sciences, Zafar Street, Tehran, Iran. nassiri@iums.ac.ir
D016009:Chi-Square Distribution; D005260:Female; D006552:Hernia, Inguinal / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007264:Inguinal Canal / Q000473:pathology / Q000601:surgery*; D008297:Male; D011446:Prospective Studies