Hernia

, Volume 19, Issue 4, pp 595–598 | Cite as

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

  • H. Kaneda
  • T. Furuya
  • K. Sugito
  • S. Goto
  • H. Kawashima
  • M. Inoue
  • T. Hosoda
  • T. Masuko
  • K. Ohashi
  • T. Ikeda
  • T. Koshinaga
  • M. Hoshino
  • H. Goto
Original Article

Abstract

Purpose

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.

Keywords

Inguinal hernia Contralateral occurrence Ultrasonography Children Prospective study 

References

  1. 1.
    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 35:1746–1748PubMedCrossRefGoogle Scholar
  2. 2.
    Tackett LD, Breuer CK, Luks FI, Caldamone AA, Breuer JG, DeLuca FG (1999) Incidence of contralateral inguinal hernia: a prospective analysis. J Pediatr Surg 34:684–688PubMedCrossRefGoogle Scholar
  3. 3.
    Stanley TL, Yi-Horng L, Michael GC (2007) Current management of hernias and hydroceles. Semin Pediatr Surg 16:50–57CrossRefGoogle Scholar
  4. 4.
    Sutcliffe JR, Taylor OM, Ambrose NS, Chapman AH (1999) The use, value and safety of herniography. Clin Radiol 54:468–472PubMedCrossRefGoogle Scholar
  5. 5.
    Powell RW (1985) Intraoperative diagnostic pneumoperitoneum in pediatric patients with unilateral inguinal hernias: the Goldstein test. J Pediatr Surg 20:418–421PubMedCrossRefGoogle Scholar
  6. 6.
    Downey EC, Maher DP, Thompson WR (1995) Diagnostic pneumoperitoneum accurately predicts the patent prosessus vaginalis. J Pediatr Surg 30:1271–1272PubMedCrossRefGoogle Scholar
  7. 7.
    Sparkman RS (1962) Bilateral exploration in inguinal hernia in juvenile patients. Surgery 51:393–406PubMedGoogle Scholar
  8. 8.
    Juda ZJ (1996) The incidence of positive contralateral inguinal exploration among preschool children—a retrospective and prospective study. J Pediatr Surg 31:656–660CrossRefGoogle Scholar
  9. 9.
    Wulkan ML, Wiener ES, VanBalen N, Vescio P (1996) Laparoscopy through the open ipsilateral sac to evaluate presence of contralateral hernia. J Pediatr Surg 31:1174–1177PubMedCrossRefGoogle Scholar
  10. 10.
    Miltenburg DM, Nuchtern JG, Jaksic T, Kozinetiz C, Brandt ML (1998) Laparoscopic evaluation of the pediatric inguinal hernia—a meta-analysis. J Pediatr Surg 33:874–879PubMedCrossRefGoogle Scholar
  11. 11.
    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 34:1213–1215PubMedCrossRefGoogle Scholar
  12. 12.
    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 43:1543–11547PubMedCrossRefGoogle Scholar
  13. 13.
    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 39:1396–1399PubMedCrossRefGoogle Scholar
  14. 14.
    Kervancioglu R, Bayram MM, Ertaskin I, Ozkur A (2000) Ultrasonographic evaluation of bilateral groins in children with unilateral inguinal hernia. Acta Radiol 41:653–657PubMedCrossRefGoogle Scholar
  15. 15.
    Chou TY, Chu CC, Diau GY, Wu CJ, Gueng MK (1996) Inguinal hernia in children: US versus exploratory surgery and intraoperative contralateral laparoscopy. Radiology 201:385–388PubMedCrossRefGoogle Scholar
  16. 16.
    Chen KC, Chu CC, Chou TY, Wu CJ (1998) Ultrasonography for inguinal hernias in boys. J Pediatr Surg 33:1784–1787PubMedCrossRefGoogle Scholar
  17. 17.
    Lawrenz K, Hollman AS, Carachi R, Cacciaguerra S (1994) Ultrasound assessment of the contralateral groin in infants with unilateral inguinal hernia. Clin Radiol 49:546–548PubMedCrossRefGoogle Scholar
  18. 18.
    Toki A, Watanabe Y, Sasaki K, Tani M, Ogura K, Wang ZQ, Wei S (2003) Ultrasonographic diagnosis for potential contralateral inguinal hernia in children. J Pediatr Surg 38:224–226PubMedCrossRefGoogle Scholar
  19. 19.
    Erez I, Rathause V, Vacian I, Zohar E, Hoppenstein D, Werner M, Lazar L, Freud E (2002) Preoperative ultrasound and intraoperative findings of inguinal hernias in children: a prospective study of 642 children. J Pediatr Surg 37:865–868PubMedCrossRefGoogle Scholar
  20. 20.
    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 18:333–337PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Kokorowski PJ, Wang HH, 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 18:311–324PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2014

Authors and Affiliations

  • H. Kaneda
    • 1
  • T. Furuya
    • 1
  • K. Sugito
    • 1
  • S. Goto
    • 1
  • H. Kawashima
    • 1
  • M. Inoue
    • 1
  • T. Hosoda
    • 1
  • T. Masuko
    • 1
  • K. Ohashi
    • 1
  • T. Ikeda
    • 1
  • T. Koshinaga
    • 1
  • M. Hoshino
    • 2
  • H. Goto
    • 2
  1. 1.Department of Pediatric SurgeryNihon University School of MedicineItabashi-KuJapan
  2. 2.Department of Pediatric SurgeryTokyo Metropolitan Ohtsuka HospitalToshimaJapan

Personalised recommendations