American Academy of Pediatrics Section on Surgery hernia survey revisited.
BACKGROUND
The aim of the study was to describe current treatment and trends in surgical management of pediatric inguinal hernias (IHs), specifically contralateral exploration.


METHODS
Surveys were sent to 599 Surgical Section members. Questions paralleled the 1993 American Academy of Pediatrics survey and addressed recent controversial topics. Statistical analysis by chi2 was performed.


RESULTS
Three hundred ninety-five (66%) surveys returned. For full-term boys with reducible IH, 79% (82%) repair electively, regardless of age or weight. For full-term girls with reducible ovary, 49% (27%) repair electively, 36% (59%) next available slot, 5% (10%) emergently (P < .01). In former premature infants, 53% (65%) repair reducible IH when convenient, regardless of age. For unilaterally presenting IH, 44% (65%) routinely explore contralateral groins in boys 2 years or younger (P < .01); 47% (84%) routinely explore girls 4 years or younger (P < .01). No significant association between routine exploration patterns and years in practice, region of country, or training program affiliation was found. Laparoscopic evaluation for contralateral IH was reported by 37% (6%), (P < .01) 1993 results italicized.


CONCLUSIONS
Reports of routine contralateral inguinal exploration had absolute decreases of 21% for boys 2 years or younger, 37% for girls 4 years or younger. There has been a shift toward elective repair for girls with reducible ovaries. Use of laparoscopy for diagnostic contralateral evaluation has increased dramatically.
Division of Pediatric Surgery, University of Minnesota, Minneapolis, MN 55455, USA. rose0437@umn.edu
Mara B
MB
Antonoff
Nathaniel S
NS
Kreykes
Daniel A
DA
Saltzman
Robert D
RD
Acton
D000740:Anemia / Q000628:therapy; D003625:Data Collection; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D005865:Gestational Age; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D010535:Laparoscopy; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy; D010372:Pediatrics; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D006848:Testicular Hydrocele / Q000601:surgery*