Abstract
To analyze the clinical presentations of female inguinal hernia and discuss the appropriate surgical approach for hernia repair. A retrospective analysis of female children who received hernia repair for unilateral or bilateral inguinal hernia between 2007 and 2019 was held. A total of 2256 hernia repairs, 1498 (66.3%) open hernia repair (OH), and 758 (33.7%) laparoscopic hernia repair (LH) were performed. There were 1693 (75.0%) unilateral, 889 (39.4%) right, 801 (35.5%) left, 3 (0.1%) unrecorded, and 563 (25.0%) bilateral patients. One hundred seven (14.1%) laparoscopic contralateral explorations led to simultaneous contralateral high ligation. Among LH patients, 3 (0.4%) received repeat LH for ipsilateral recurrent hernia (IRH). Among OH patients, 19 (1.3%) underwent another OH for metachronous contralateral hernia (MCH). There was no significant difference between OH and LH for IRH (P = 0.015), unlike for MCH (P < 0.010). There was a higher percentage of unilateral inguinal hernia than bilateral, with a right-side bias. Despite the associated learning curve, this study advocates for LH as it is a safe procedure that allows for efficient and effective contralateral exploration without increasing total anesthesia time. We also advocate for simultaneous contralateral hernia repair as it would potentially reduce the need for a second surgery and the financial and emotional burden that parents experience with surgery.
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References
Nakashima M, Ide K, Kawakami K (2019) Laparoscopic versus open repair for inguinal hernia in children: a retrospective cohort study. Surg Today 49:1044–1050. https://doi.org/10.1007/s00595-019-01847-0
Grosfeld JL (1989) Current concepts in inguinal hernia in infants and children. World J Surg 13:506–515. https://doi.org/10.1007/BF01658863
Rajput A, Gauderer MWL, Hack M (1992) Inguinal hernias in very low birth weight infants: Incidence and timing of repair. J Pediatr Surg 27:1322–1324. https://doi.org/10.1016/0022-3468(92)90287-H
Fu Y-W, Pan M-L, Hsu Y-J, Chin T-W (2018) A nationwide survey of incidence rates and risk factors of inguinal hernia in preterm children. Pediatr Surg Int 34:91–95. https://doi.org/10.1007/s00383-017-4222-0
Yeap E, Nataraja RM, Pacilli M (2020) Inguinal hernias in children. Australian Journal of General Practice 49(1-2), 38-43. https://doi.org/10.31128/AJGP-08-19-5037
Öberg S, Andresen K, Rosenberg J (2017) Etiology of inguinal hernias: a comprehensive review. Front Surg 4:52. https://doi.org/10.3389/fsurg.2017.00052
Esposito C, Gargiulo F, Farina A, Del Conte F, Cortese G, Servillo G et al (2019) Laparoscopic treatment of inguinal ovarian hernia in female infants and children: standardizing the technique. J Laparoendosc Adv Surg Tech 29:568–572. https://doi.org/10.1089/lap.2018.0630
Chan D, Kwon JK, Lagomarsino EM, Veltkamp JG, Yang MS, Pfeifer CM (2019) Canal of Nuck hernias. Acta Radiol Open 8:205846011988986. https://doi.org/10.1177/2058460119889867
Chen R, Tang S, Lu Q, Zhang X, Zhang W, Chen Z, Qi S (2020) A 9-year experience study of single-port micro-laparoscopic repair of pediatric inguinal hernia using a simple needle. Hernia 24:639–644. https://doi.org/10.1007/s10029-019-02079-4
Brandt ML (2008) Pediatric Hernias.pdf. Surg Clin North Am 88:24–43. https://doi.org/10.1016/j.suc.2007.11.006
Kokorowski PJ, Wang H-HS, Routh JC, Hubert KC, Nelson CP (2014) Evaluation of the contralateral inguinal ring in clinically unilateral inguinal hernia: a systematic review and meta-analysis. Hernia 18:311–324. https://doi.org/10.1007/s10029-013-1146-z
Raveenthiran V, Agarwal P (2017) Choice of Repairing Inguinal Hernia in Children: Open Versus Laparoscopy. Indian J Pediatr 84:555–563. https://doi.org/10.1007/s12098-017-2354-9
Atwell JD (1962) Inguinal hernia in female infants and children. Br J Surg 50:294–297. https://doi.org/10.1002/bjs.18005022110
Zeng K, Murphy J, Wilson EE (2019) Female reproductive structures found in inguinal hernia sacs: A retrospective review. J Pediatr Surg 54:2134–2137. https://doi.org/10.1016/j.jpedsurg.2019.03.018
Dreuning K, Maat S, Twisk J, van Heurn E, Derikx J (2019) Laparoscopic versus open pediatric inguinal hernia repair: state-of-the-art comparison and future perspectives from a meta-analysis. Surg Endosc 33:3177–3191. https://doi.org/10.1007/s00464-019-06960-2
Zamakhshary M, To, Guan J, Langer JC (2008) Risk of incarceration of inguinal hernia among infants and young children awaiting elective surgery. Can Med Assoc J 179:1001–1005. https://doi.org/10.1503/cmaj.070923
Lipskar AM, Soffer SZ, Glick RD, Rosen NG, Levitt MA, Hong AR (2010) Laparoscopic inguinal hernia inversion and ligation in female children: a review of 173 consecutive cases at a single institution. J Pediatr Surg 45:1370–1374. https://doi.org/10.1016/j.jpedsurg.2010.02.113
Deeb A, Hughes IA (2005) Inguinal hernia in female infants: a cue to check the sex chromosomes? BJU Int 96:401–403. https://doi.org/10.1111/j.1464-410X.2005.05639.x
Kantor N, Travis N, Wayne C, Nasr A (2019) Laparoscopic versus open inguinal hernia repair in children: which is the true gold-standard? A systematic review and meta-analysis. Pediatr Surg Int 35:1013–1026. https://doi.org/10.1007/s00383-019-04521-1
Yoshizawa J, Ashizuka S, Kuwashima N, Kurobe M, Tanaka K, Ohashi S, Hiramatsu T, Baba Y, Kanamori D, Kaji S, Ohki T (2013) Laparoscopic percutaneous extraperitoneal closure for inguinal hernia: learning curve for attending surgeons and residents. Pediatr Surg Int 29:1281–1285. https://doi.org/10.1007/s00383-013-3337-1
Celebi S, Uysal AI, Inal FY, Yildiz A (2014) A single-blinded, randomized comparison of laparoscopic versus open bilateral hernia repair in boys. J Laparoendosc Adv Surg Tech 24:117–121. https://doi.org/10.1089/lap.2013.0397
Koivusalo AI, Korpela R, Wirtavuori K, Piiparinen S, Rintala RJ, Pakarinen MP (2009) A single-blinded, randomized comparison of laparoscopic versus open hernia repair in children. PEDIATRICS 123:332–337. https://doi.org/10.1542/peds.2007-3752
Zakaria OM (2018) Patent contralateral processus vaginalis in infants and children: is herniotomy justified? Oman Med J 33:481–485. https://doi.org/10.5001/omj.2018.89
Zhu LL, Xu WJ, Liu JB, Huang X, Lv ZB (2017) Comparison of laparoscopic hernia repair and open herniotomy in children: a retrospective cohort study. Hernia 21:417–423. https://doi.org/10.1007/s10029-017-1607-x
Toki A, Watanabe Y, Sasaki K, Tani M, Ogura K, Wang Z-Q (2003) Adopt a wait-and-see attitude for patent processus vaginalis in neonates. J Pediatr Surg 38:1371–1373. https://doi.org/10.1016/S0022-3468(03)00398-1
Kemmotsu H, Oshima Y. The features of contralateral manifestations after the repair of unilateral inguinal hernia n.d.:5.
Hoshino M, Sugito K, Kawashima H, Goto S, Kaneda H, Furuya T, Hosoda T, Masuko T, Ohashi K, Inoue M, Ikeda T, Tomita R, Koshinaga T (2014) Prediction of contralateral inguinal hernias in children: a prospective study of 357 unilateral inguinal hernias. Hernia 18:333–337. https://doi.org/10.1007/s10029-013-1099-2
Tackett LD, Breuer CK, Luks FI, Caldamone AA, Breuer JG, DeLuca FG et al (1999) Incidence of contralateral inguinal hernia: a prospective analysis. J Pediatr Surg 34:684–688. https://doi.org/10.1016/S0022-3468(99)90356-1
Lee C-H, Chen Y, Cheng C-F, Yao C-L, Wu J-C, Yin W-Y, Chen JH (2016) Incidence of and risk factors for pediatric metachronous contralateral inguinal hernia: analysis of a 17-year nationwide database in Taiwan. PLoS ONE 11:e0163278. https://doi.org/10.1371/journal.pone.0163278
Wenk K, Sick B, Sasse T, Moehrlen U, Meuli M, Vuille-dit-Bille RN (2015) Incidence of metachronous contralateral inguinal hernias in children following unilateral repair — a meta-analysis of prospective studies. J Pediatr Surg 50:2147–2154. https://doi.org/10.1016/j.jpedsurg.2015.08.056
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Tan, S.S., Wang, K., Xiao, Y. et al. Single-Center 12-Year Analysis of Inguinal Hernia in Female Children. Indian J Surg 83, 1407–1412 (2021). https://doi.org/10.1007/s12262-020-02676-z
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DOI: https://doi.org/10.1007/s12262-020-02676-z