Abstract
Introduction
Laparoscopic percutaneous extraperitoneal closure (LPEC) allows the surgeon to look for contralateral patent processus vaginalis (CPPV) directly. We investigated the incidence of CPPV in relation to age at LPEC.
Methods
Following Institutional Review Board approval, 1232 patients ranging in age from 2 months old to 15 years old (median 4.7 years), who underwent LPEC, were investigated retrospectively. Patients were divided into five groups based on their age at surgery: younger than 1, 1–2, 2–4, 4–6 years, and older than 6 years. The incidence of CPPV being detected by preoperative ultrasonography or laparoscopy was compared among these groups. Statistical analyses were performed using the Chi-square test or Cochran–Armitage trend test, and p < 0.05 was considered significant.
Results
The incidence of CPPV detected by ultrasonography decreased as the age increased (p < 0.0001), whereas the incidence of CPPV newly revealed by laparoscopy increased as age increased (p = 0.0001). There were no significant differences in the incidence of CPPV in patients with unilateral hernia among the five age groups (p = 0.74).
Conclusions
These results showed that the incidence of CPPV in patients with unilateral inguinal hernia did not change in relation to their age.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Takehara H, Yakabe S, Kameoka K. Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in three pediatric surgical institutions. J Pediatr Surg. 2006;41:1999–2003.
Rowe MI, Copelson LW, Clatworthy HW. The patent processus vaginalis and the inguinal hernia. J Pediatr Surg. 1969;4:102–7.
Kiesewetter WB, Oh KS. Unilateral inguinal hernias in children: what about the opposite side? Arch Surg (Chicago Ill: 1960). 1980;115:1443–5.
Timberlake GA, Ochsner MG, Powell RW. Diagnostic pneumoperitoneum in the pediatric patient with a unilateral inguinal hernia. Arch Surg (Chicago, Ill: 1960). 1989;124:721–3.
Saad S, Mansson J, Saad A, et al. Ten-year review of groin laparoscopy in 1001 pediatric patients with clinical unilateral inguinal hernia: an improved technique with transhernia multiple-channel scope. J Pediatr Surg. 2011;46:1011–4.
Sparkman RS. Bilateral exploration in inguinal hernia in juvenile patients. Review and appraisal. Surgery. 1962;51:393–406.
Bhatia AM, Gow KW, Heiss KF, et al. Is the use of laparoscopy to determine presence of contralateral patent processus vaginalis justified in children greater than 2 years of age? J Pediatr Surg. 2004;39:778–81.
Lazar DA, Lee TC, Almulhim SI, et al. Transinguinal laparoscopic exploration for identification of contralateral inguinal hernias in pediatric patients. J Pediatr Surg. 2011;46:2349–52.
Hall NJ, Choi W, Pierro A, et al. Age-related probability of contralateral processus vaginalis patency in children with unilateral inguinal hernia. Pediatr Surg Int. 2012;28:1085–8.
Saka R, Okuyama H, Sasaki T, et al. Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernias and hydroceles in children: a comparison with traditional open repair. J Laparoendosc Adv Surg Tech Part A. 2014;24:55–8.
Conflict of interest
All authors have no conflicts of interest to declare.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sumida, W., Watanabe, Y., Takasu, H. et al. Incidence of contralateral patent processus vaginalis in relation to age at laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia. Surg Today 46, 466–470 (2016). https://doi.org/10.1007/s00595-015-1205-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-015-1205-4