title: Preoperative ultrasonographic evaluation of the contralateral patent processus vaginalis at the level of the internal inguinal ring is useful for predicting contralateral inguinal hernias in children: a prospective analysis.
abstract: OBJECTIVE
  The current study aimed to verify the usefulness of preoperative ultrasonographic evaluation of contralateral patent processus vaginalis (PPV) at the level of the internal inguinal ring.
  
  
  METHODS
  This was a prospective study of patients undergoing unilateral inguinal hernia repair at two institutions during 2010-2011. The sex, age at initial operation, birth weight, initial operation side, and the preoperative diameter of the contralateral PPV as determined using ultrasonography (US) were recorded. We analyzed the incidence of contralateral inguinal hernia, risk factors, and the usefulness of the preoperative major diameter of the contralateral PPV. The follow-up period was 36 months.
  
  
  RESULTS
  All 105 patients who underwent unilateral hernia repair completed 36 months of follow-up, during which 11 patients (10.5 %) developed a contralateral hernia. The following covariates were not associated with contralateral hernia development: sex (p = 0.350), age (p = 0.185), birth weight (p = 0.939), and initial operation side (p = 0.350). The preoperative major diameter of the contralateral PPV determined using US was significantly wider among patients with a contralateral hernia than those without a contralateral hernia (p = 0.001). When the 105 patients were divided into two groups according to cut-off values of the preoperative major diameter of the contralateral PPV (wide group, >2.0 mm; narrow group, ≤2.0 mm), a significant association was observed between the preoperative major diameter of the contralateral PPV and patient outcomes (p = 0.001).
  
  
  CONCLUSIONS
  We used US and confirmed the usefulness of a preoperative evaluation of the major diameter of the contralateral PPV at the level of the internal inguinal ring in pediatric patients with unilateral inguinal hernias.
authors.affiliation: Department of Pediatric Surgery, Nihon University School of Medicine, 30-1, Ohyaguchi-Kamicho, Itabashi-Ku, Tokyo, 173-8610, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kaneda
authors.forename: T
authors.initials: T
authors.lastname: Furuya
authors.forename: K
authors.initials: K
authors.lastname: Sugito
authors.forename: S
authors.initials: S
authors.lastname: Goto
authors.forename: H
authors.initials: H
authors.lastname: Kawashima
authors.forename: M
authors.initials: M
authors.lastname: Inoue
authors.forename: T
authors.initials: T
authors.lastname: Hosoda
authors.forename: T
authors.initials: T
authors.lastname: Masuko
authors.forename: K
authors.initials: K
authors.lastname: Ohashi
authors.forename: T
authors.initials: T
authors.lastname: Ikeda
authors.forename: T
authors.initials: T
authors.lastname: Koshinaga
authors.forename: M
authors.initials: M
authors.lastname: Hoshino
authors.forename: H
authors.initials: H
authors.lastname: Goto
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007264:Inguinal Canal / Q000000981:diagnostic imaging*; D008297:Male; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography