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Published in: Hernia 3/2014

Open Access 01-06-2014 | Original Article

Prediction of contralateral inguinal hernias in children: a prospective study of 357 unilateral inguinal hernias

Authors: M. Hoshino, K. Sugito, H. Kawashima, S. Goto, H. Kaneda, T. Furuya, T. Hosoda, T. Masuko, K. Ohashi, M. Inoue, T. Ikeda, R. Tomita, T. Koshinaga

Published in: Hernia | Issue 3/2014

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Abstract

Purpose

Previously, we established a pre-operative risk scoring system to predict contralateral inguinal hernia in children with unilateral inguinal hernias. The current study aimed to verify the usefulness of our pre-operative scoring system.

Methods

This was a prospective study of patients undergoing unilateral inguinal hernia repair from 2006 to 2009 at a single institution. Gender, age at initial operation, birth weight, initial operation side, and the pre-operative risk score were recorded. We analyzed the incidence of contralateral inguinal hernia, risk factors, and the usefulness of our pre-operative risk scoring system. The follow-up period was 36 months. We used forward multiple logistic regression analysis to predict contralateral hernia.

Results

Of the 372 patients who underwent unilateral hernia repair, 357 (96.0 %) were completely followed-up for 36 months, and 23 patients (6.4 %) developed a contralateral hernia. Left-sided hernia (OR = 5.5, 95 %, CI = 1.3–24.3, p = 0.023) was associated with an increased risk of contralateral hernia. The following covariates were not associated with contralateral hernia development: gender (p = 0.702), age (p = 0.215), and birth weight (p = 0.301). The pre-operative risk score (cut-off point = 4.5) of the patients with a contralateral hernia was significantly higher, compared with the patients without a contralateral hernia using the area under the receiver operating characteristic curve (p = 0.024).

Conclusions

Using multivariate analysis, we confirmed usefulness of our pre-operative scoring system and initial side of the inguinal hernia, together, for the prediction of contralateral inguinal hernia in children.
Literature
1.
go back to reference Ikeda H, Suzuki N, Takahashi A, Kuroiwa M, Sakai M, Tsuchida Y (2000) Risk of contralateral manifestation in children with unilateral inguinal hernia: should hernia in children be treated contralaterally? J Pediatr Surg 35:1746–1748PubMedCrossRef Ikeda H, Suzuki N, Takahashi A, Kuroiwa M, Sakai M, Tsuchida Y (2000) Risk of contralateral manifestation in children with unilateral inguinal hernia: should hernia in children be treated contralaterally? J Pediatr Surg 35:1746–1748PubMedCrossRef
2.
go back to reference Tackett LD, Breuer CK, Luks FI, Caldamone AA, Breuer JG, DeLuca FG (1999) Incidence of contralateral inguinal hernia: a prospective analysis. J Pediatr Surg 34:684–688PubMedCrossRef Tackett LD, Breuer CK, Luks FI, Caldamone AA, Breuer JG, DeLuca FG (1999) Incidence of contralateral inguinal hernia: a prospective analysis. J Pediatr Surg 34:684–688PubMedCrossRef
3.
go back to reference Stanley TL, Yi-Horng L, Michael GC (2007) Current management of hernias and hydroceles. Seminars in Pediatr Surg 16:50–57CrossRef Stanley TL, Yi-Horng L, Michael GC (2007) Current management of hernias and hydroceles. Seminars in Pediatr Surg 16:50–57CrossRef
4.
go back to reference Hoshino M, Sugito K, Ohashi K, Inoue M, Ikeda T, Koshinaga T (2011) The statistical analysis of inguinal hernia in children—for evidence based medicine. Jpn J Pediatr Surg 47:213–219 Hoshino M, Sugito K, Ohashi K, Inoue M, Ikeda T, Koshinaga T (2011) The statistical analysis of inguinal hernia in children—for evidence based medicine. Jpn J Pediatr Surg 47:213–219
5.
go back to reference Sutcliffe JR, Taylor OM, Ambrose NS, Chapman AH (1999) The use, value and safety of herniography. Clin Radiol 54:468–472PubMedCrossRef Sutcliffe JR, Taylor OM, Ambrose NS, Chapman AH (1999) The use, value and safety of herniography. Clin Radiol 54:468–472PubMedCrossRef
6.
go back to reference Powell RW (1985) Intraoperative diagnostic pneumoperitoneum in pediatric patients with unilateral inguinal hernias: the Goldstein test. J Pediatr Surg 20:418–421PubMedCrossRef Powell RW (1985) Intraoperative diagnostic pneumoperitoneum in pediatric patients with unilateral inguinal hernias: the Goldstein test. J Pediatr Surg 20:418–421PubMedCrossRef
7.
go back to reference Downey EC, Maher DP, Thompson WR (1995) Diagnostic pneumoperitoneum accurately predicts the patent prosessus vaginalis. J Pediatr Surg 30:1271–1272PubMedCrossRef Downey EC, Maher DP, Thompson WR (1995) Diagnostic pneumoperitoneum accurately predicts the patent prosessus vaginalis. J Pediatr Surg 30:1271–1272PubMedCrossRef
8.
go back to reference Sparkman RS (1962) Bilateral exploration in inguinal hernia in juvenile patients. Surgery 51:393–406PubMed Sparkman RS (1962) Bilateral exploration in inguinal hernia in juvenile patients. Surgery 51:393–406PubMed
9.
go back to reference Juda ZJ (1996) The incidence of positive contralateral inguinal exploration among preschool children–a retrospective and prospective study. J Pediatr Surg 31:656–660CrossRef Juda ZJ (1996) The incidence of positive contralateral inguinal exploration among preschool children–a retrospective and prospective study. J Pediatr Surg 31:656–660CrossRef
10.
go back to reference Wulkan ML, Wiener ES, VanBalen N, Vescio P (1996) Laparoscopy through the open ipsilateral sac to evaluate presence of contralateral hernia. J Pediatr Surg 31:1174–1177PubMedCrossRef Wulkan ML, Wiener ES, VanBalen N, Vescio P (1996) Laparoscopy through the open ipsilateral sac to evaluate presence of contralateral hernia. J Pediatr Surg 31:1174–1177PubMedCrossRef
11.
go back to reference Miltenburg DM, Nuchtern JG, Jaksic T, Kozinetiz C, Brandt ML (1998) Laparoscopic evaluation of the pediatric inguinal hernia—a meta-analysis. J Pediatr Surg 33:874–879PubMedCrossRef Miltenburg DM, Nuchtern JG, Jaksic T, Kozinetiz C, Brandt ML (1998) Laparoscopic evaluation of the pediatric inguinal hernia—a meta-analysis. J Pediatr Surg 33:874–879PubMedCrossRef
12.
go back to reference Van Glabeke E, Khairouni A, Gall O, Le Pointe HD, Jaby O, Larroquet M, Kotobi H, Chevet JB, Andry G, Gruner M (1999) Laparoscopic diagnosis of contralateral patent processus vaginalis in children under 1 year of age with unilateral inguinal hernia: comparison with herniography. J Pediatr Surg 34:1213–1215PubMedCrossRef Van Glabeke E, Khairouni A, Gall O, Le Pointe HD, Jaby O, Larroquet M, Kotobi H, Chevet JB, Andry G, Gruner M (1999) Laparoscopic diagnosis of contralateral patent processus vaginalis in children under 1 year of age with unilateral inguinal hernia: comparison with herniography. J Pediatr Surg 34:1213–1215PubMedCrossRef
13.
go back to reference Watanabe T, Nakano M, Endo M (2008) An investigation on the mechanism of contralateral manifestations after unilateral herniorrhaphy in children based on laparoscopic evaluation. J Pediatr Surg 43:1543–11547PubMedCrossRef Watanabe T, Nakano M, Endo M (2008) An investigation on the mechanism of contralateral manifestations after unilateral herniorrhaphy in children based on laparoscopic evaluation. J Pediatr Surg 43:1543–11547PubMedCrossRef
14.
go back to reference Hata S, Takahashi Y, Nakamura T, Suzuki R, Kitada M, Shimano T (2004) Preoperative sonographic evaluation is a useful method of detection contralateral patent processus vaginalis in pediatric patients with unilateral inguinal hernia. J Pediatr Surg 39:1396–1399PubMedCrossRef Hata S, Takahashi Y, Nakamura T, Suzuki R, Kitada M, Shimano T (2004) Preoperative sonographic evaluation is a useful method of detection contralateral patent processus vaginalis in pediatric patients with unilateral inguinal hernia. J Pediatr Surg 39:1396–1399PubMedCrossRef
15.
go back to reference Miltenburg DM, Nuchtern JG, Jaksic T, Kozinetz CA, Brandt ML (1997) Meta-analysis of the risk of metachronous hernia in infants and children. Am J Surg 174:741–744PubMedCrossRef Miltenburg DM, Nuchtern JG, Jaksic T, Kozinetz CA, Brandt ML (1997) Meta-analysis of the risk of metachronous hernia in infants and children. Am J Surg 174:741–744PubMedCrossRef
16.
go back to reference Manoharan S, Samarakkody U, Kulkarni M, Blakelock R, Brown S (2005) Evidence-based change of practice in the management of unilateral inguinal hernia. J Pediatr Surg 40:1163–1166PubMedCrossRef Manoharan S, Samarakkody U, Kulkarni M, Blakelock R, Brown S (2005) Evidence-based change of practice in the management of unilateral inguinal hernia. J Pediatr Surg 40:1163–1166PubMedCrossRef
17.
go back to reference Zamakhshardy M, Ein A, Ein SH, Wales PW (2009) Predictors of metachronous inguinal hernias in children. Pediatr Surg Int 25:69–71PubMedCrossRef Zamakhshardy M, Ein A, Ein SH, Wales PW (2009) Predictors of metachronous inguinal hernias in children. Pediatr Surg Int 25:69–71PubMedCrossRef
Metadata
Title
Prediction of contralateral inguinal hernias in children: a prospective study of 357 unilateral inguinal hernias
Authors
M. Hoshino
K. Sugito
H. Kawashima
S. Goto
H. Kaneda
T. Furuya
T. Hosoda
T. Masuko
K. Ohashi
M. Inoue
T. Ikeda
R. Tomita
T. Koshinaga
Publication date
01-06-2014
Publisher
Springer Paris
Published in
Hernia / Issue 3/2014
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-013-1099-2

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