title: Effects of insistent screening for contralateral patent processus vaginalis in laparoscopic percutaneous extraperitoneal closure to prevent metachronous contralateral onset of pediatric inguinal hernia.
abstract: OBJECTIVE
  Laparoscopic percutaneous extraperitoneal closure (LPEC) is known to reduce the incidence of metachronous contralateral hernia (MCH) compared to conventional hernia repair. We herein describe the effects of insistent screening for an irregular orifice of the contralateral patent processus vaginalis (CPPV).
  
  
  METHODS
  All patients who underwent LPEC between 2003 and 2013 were reviewed. We started insistent screening for a CPPV in July 2010. The surgically treated cases before June 2010 were assigned to the former group, while those treated after July 2010 were in the latter group. The data were retrospectively collected from medical records. The statistical analysis was performed using the Mann-Whitney U test or Chi square test. A value of P < 0.05 was considered to be significant.
  
  
  RESULTS
  A total of 1113 patients (514 males and 599 females) ranging in age from 3 months old to 15 years old (median 4.6 years old), were reviewed. Of the 626 patients in the former group, a CPPV was detected in 227 patients. Of the 487 patients in the latter group, a CPPV was detected in 271 patients. The incidence of a CPPV significantly increased over time (P < 0.001). We encountered five cases of MCH, all of which belonged to the former group (P = 0.048).
  
  
  CONCLUSIONS
  The increased detection of a CPPV by insistent screening seemed to cause a decrease in the incidence of MCH.
authors.affiliation: Department of Pediatric Surgery, Aichi Children's Health and Medical Center, 7-426, Morioka-cho, Obu, Aichi, 474-8710, Japan. wsumida288gto@yahoo.co.jp.
authors.forename: Wataru
authors.initials: W
authors.lastname: Sumida
authors.affiliation: Department of Pediatric Surgery, Aichi Children's Health and Medical Center, 7-426, Morioka-cho, Obu, Aichi, 474-8710, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Pediatric Surgery, Aichi Children's Health and Medical Center, 7-426, Morioka-cho, Obu, Aichi, 474-8710, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Takasu
authors.affiliation: Department of Pediatric Surgery, Aichi Children's Health and Medical Center, 7-426, Morioka-cho, Obu, Aichi, 474-8710, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Oshima
authors.affiliation: Department of Pediatric Surgery, Aichi Children's Health and Medical Center, 7-426, Morioka-cho, Obu, Aichi, 474-8710, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Komatsuzaki
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis*; D005832:Genital Diseases, Male / Q000175:diagnosis*; D006552:Hernia, Inguinal / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007223:Infant; D010535:Laparoscopy; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies
keywords: Contralateral patent processus vaginalis; Laparoscopic hernia closure; Metachronous contralateral hernia; Pediatric inguinal hernia