title: Contralateral inguinal exploration in premature neonates: is it necessary?
abstract: OBJECTIVE
  The purpose of this study was to review our management of neonatal inguinal hernias in premature infants over a 5-year period to ascertain any change in practice.
  
  
  METHODS
  Premature infants who underwent inguinal herniotomy between 2002 and 2006 were identified. Case notes were analyzed recording patient demographics, primary side, complications, recurrence and how many re-presented with a metachronous hernia.
  
  
  RESULTS
  172 preterm infants were identified: 162 males (94.2%) and 10 females (5.8%). Median gestation was 31 weeks (25-36.7). Eighteen (10.4%) were incarcerated. Median age at surgery was 66.5 days (0-284). Thirty-two (18.6%) had bilateral hernias. Of the 63 who underwent unilateral herniotomy, 9 (14.3%) re-presented with a metachronous hernia. Median time to returning was 24 days. The number of contralateral explorations decreased over the study period. The complication rate was 6.4%. Median follow-up was 2.83 years (0.33-5.4).
  
  
  CONCLUSIONS
  This is one of the largest series showing the current practice in managing preterm infants with inguinal hernia. There are limitations to this study and the follow-up period is short. The value of contralateral groin exploration in premature neonates remains doubtful and we have shown that the overall practice has changed.
authors.affiliation: Department of Surgical Pediatrics, Royal Hospital for Sick Children, Dalnair Street, Glasgow, G3 8SJ, UK. mairisteven@doctors.org.uk
authors.forename: Mairi
authors.initials: M
authors.lastname: Steven
authors.forename: Owen
authors.initials: O
authors.lastname: Greene
authors.forename: Adam
authors.initials: A
authors.lastname: Nelson
authors.forename: Nicola
authors.initials: N
authors.lastname: Brindley
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000473:pathology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D019564:Unnecessary Procedures / Q000639:trends
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