Document Detail


The pediatric inguinal hernia: is contralateral exploration justified?
MedLine Citation:
PMID:  7786359     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine if contralateral inguinal hernia exploration is justified we decided to study our experience with 161 consecutive cases who underwent bilateral repair during a 30 months period. 61% of the population were infants younger than two years of age, and 19% premature babies. 69 pts presented with an RIH, 47 with an LIH and 45 pts with BIH. 16% suffered an episode of preoperative incarceration which were all reduced satisfactorily and operated promptly. A positive contralateral finding (either a hernial sac or a patent processus vaginalis) was identified in 74% RIH and 72% LIH patients upon exploration. No incidence of testicular edema/atrophy, vas deferens injury, or recurrence was reported in the six-year follow-up of the study. Statistical analysis of the contralateral findings during surgery with sex, gestational age and age at operation showed that females and infants younger than two months of age had a higher probability of having positive findings. We could not show that prematurity or left-sided hernias were associated with a higher positive contralateral rate. The major benefit of contralateral exploration is based on the fact that it allows discovery and elimination of a patent processus vaginalis so a hernia cannot develop subsequently. We conclude by establishing certain criteria that justifies the routine contralateral exploration of the pediatric hernia: the surgeon should be experienced in child care, associated conditions should not increase the surgical risks significantly, time-consuming dissections of the cord structures should be discouraged, and the operating time should be kept to a minimum.
Authors:
H L Lugo Vicente
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Boletín de la Asociación Médica de Puerto Rico     Volume:  87     ISSN:  0004-4849     ISO Abbreviation:  Bol Asoc Med P R     Publication Date:    1995 Jan-Feb
Date Detail:
Created Date:  1995-07-25     Completed Date:  1995-07-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7505267     Medline TA:  Bol Asoc Med P R     Country:  PUERTO RICO    
Other Details:
Languages:  eng     Pagination:  8-11     Citation Subset:  IM    
Affiliation:
Department of Surgery, Universidad Central del Caribe, School of Medicine, San Juan, PR 00922-0426.
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Female
Hernia, Inguinal / surgery*
Humans
Infant
Infant, Newborn
Male

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