Contralateral exploration is not mandatory in unilateral inguinal hernia in children: a prospective 6-year study

2002 ◽  
Vol 18 (5-6) ◽  
pp. 470-471 ◽  
Author(s):  
Javad Nassiri
Keyword(s):  
Inguinal Hernia ◽  
Contralateral Exploration ◽  
Unilateral Inguinal Hernia ◽  
Inguinal Hernia In Children

scholarly journals Contralateral exploration and repair of occult inguinal hernias during laparoscopic inguinal hernia repair: systematic review and Markov decision process

BJS Open ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
N H Dhanani ◽  
O A Olavarria ◽  
S Wootton ◽  
M Petsalis ◽  
N B Lyons ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Markov Decision Process ◽  
Decision Process ◽  
Expectant Management ◽  
Contralateral Exploration ◽  
Unilateral Inguinal Hernia ◽  
Inguinal Hernias ◽  
Markov Decision

Abstract Background Contralateral clinically occult hernias are frequently noted at the time of laparoscopic unilateral inguinal hernia repair. There is no consensus on the role of contralateral exploration and repair. This systematic review assessed the safety and efficacy of operative repair of occult contralateral inguinal hernias found during unilateral repair. Methods PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to February 2020. Adults diagnosed with a unilateral inguinal hernia undergoing laparoscopic repair were included. The primary outcome was the incidence of occult contralateral hernias. Summative outcomes of operative and expectant management were reported along with development of a Markov decision process. Results Thirteen studies (1 randomized trial, 12 observational cohorts) with 5000 patients were included. The incidence of occult contralateral inguinal hernias was 14.6 (range 7.3–50.1) per cent. Among patients who underwent repair, 10.5 (4.3–17.0) per cent experienced a postoperative complication. Of patients managed expectantly, 29 per cent later required elective repair for symptoms. Mean follow-up was 36 (range 2–218) months. Using a Markov decision process, it was calculated that, for every 1000 patients undergoing unilateral inguinal hernia repair, contralateral exploration would identify 150 patients with an occult hernia. Repair would result in 15 patients developing a postoperative complication and 105 undergoing unnecessary repair. Alternatively, expectant management would result in 45 patients requiring subsequent repair. Conclusion Contralateral repair is not warranted in patients with occult hernias diagnosed at the time of elective hernia repair. The evidence is largely based on observational studies at high risk of bias.

scholarly journals Contralateral surgical exploration during inguinal hernia repair in infants (HERNIIA trial): study protocol for a multi-centre, randomised controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kelly M. A. Dreuning ◽  
Maurits W. van Tulder ◽  
Jasper V. Been ◽  
Maroeska M. Rovers ◽  
Jurgen C. de Graaff ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Hernia Repair ◽  
Controlled Trial ◽  
Surgical Exploration ◽  
Contralateral Exploration ◽  
Unilateral Inguinal Hernia ◽  
Randomised Controlled

Abstract Background The incidence of metachronous contralateral inguinal hernia (MCIH) is high in infants with an inguinal hernia (5–30%), with the highest risk in infants aged 6 months or younger. MCIH is associated with the risk of incarceration and necessitates a second operation. This might be avoided by contralateral exploration during primary surgery. However, contralateral exploration may be unnecessary, leads to additional operating time and costs and may result in additional complications of surgery and anaesthesia. Thus, there is no consensus whether contralateral exploration should be performed routinely. Methods The Hernia-Exploration-oR-Not-In-Infants-Analysis (HERNIIA) study is a multicentre randomised controlled trial with an economic evaluation alongside to study the (cost-)effectiveness of contralateral exploration during unilateral hernia repair. Infants aged 6 months or younger who need to undergo primary unilateral hernia repair will be randomised to contralateral exploration or no contralateral exploration (n = 378 patients). Primary endpoint is the proportion of infants that need to undergo a second operation related to inguinal hernia within 1 year after primary repair. Secondary endpoints include (a) total duration of operation(s) (including anaesthesia time) and hospital admission(s); (b) complications of anaesthesia and surgery; and (c) participants’ health-related quality of life and distress and anxiety of their families, all assessed within 1 year after primary hernia repair. Statistical testing will be performed two-sided with α = .05 and according to the intention-to-treat principle. Logistic regression analysis will be performed adjusted for centre and possible confounders. The economic evaluation will be performed from a societal perspective and all relevant costs will be measured, valued and analysed. Discussion This study evaluates the effectiveness and cost-effectiveness of contralateral surgical exploration during unilateral inguinal hernia repair in children younger than 6 months with a unilateral inguinal hernia. Trial registration ClinicalTrials.govNCT03623893. Registered on August 9, 2018 Netherlands Trial Register NL7194. Registered on July 24, 2018 Central Committee on Research Involving Human Subjects (CCMO) NL59817.029.18. Registered on July 3, 2018

scholarly journals Investigating the Diagnostic Value of Ultrasound in Determining the Opposite Inguinal Hernia in Children with Unilateral Inguinal Hernia Diagnosis

2020 ◽  
pp. 1-6
Author(s):  
Ashjaei Bahar ◽  
Ashjaei Bahar ◽  
Amiri Shakiba ◽  
Najdi Fatemeh ◽  
Movahedi Jadid Merisa
Keyword(s):  
Inguinal Hernia ◽  
Clinical Examination ◽  
Medical Center ◽  
Diagnostic Value ◽  
Bilateral Inguinal Hernia ◽  
Cross Sectional ◽  
Unilateral Inguinal Hernia ◽  
Center Hospital ◽  
Inguinal Hernia In Children

Objective: This study was conducted to evaluate and compare the results of ultrasound and clinical examination in the diagnosis of inguinal hernia in children and also to evaluate the benefits and complications of ultrasound in these children. Study Design: This study, was performed by a cross-sectional method in Children's Medical Center Hospital during 2013-2014 years and follow up was done until July 2020 with the help of a questionnaire from 70 children who had been referred due to unilateral inguinal hernia symptoms. All 70 children underwent Ultrasonographic evaluation and the results of the ultrasound were compared with the initial clinical examination and then with surgery and follow up. Results: In 95.7% of cases, uni or bilateral inguinal hernia was correctly diagnosed by ultrasound. Ultrasound revealed 13.4% of cases were bilateral and 86.6% were unilateral, all of which were confirmed by surgery. In 17.1% of cases, although they were referred with the chief complaint and clinical examination of unilateral inguinal hernia, Bilateral diagnosis was made for them during the ultrasound, and during the surgery, 75% of them were confirmed to have bilateral inguinal hernia. Conclusion: Ultrasound is effective in diagnosing the opposite side of the hernia in cases with unilateral hernia.

scholarly journals Is Routine Contralateral Exploration Necessary while Doing Herniotomy for Unilateral Inguinal Hernia in Children?

1970 ◽  
Vol 14 (2) ◽  
pp. 53-55
Author(s):  
Kamal M Choudhury ◽  
Md Abu Jafor ◽  
Shafiqul Haque
Keyword(s):  
Inguinal Hernia ◽  
Paediatric Surgery ◽  
Older Children ◽  
College Hospital ◽  
Contralateral Exploration ◽  
Medical College ◽  
Unilateral Inguinal Hernia ◽  
Low Incidence ◽  
Medical University ◽  
Contralateral Hernia

Routine contralateral exploration in infants and children with unilateral inguinal hernia has been practiced by a number of paediatric surgeons based on a presumed high incidence of patent processus vaginalis. Our aim is to report the incidence of contralateral manifestations after repair of unilateral inguinal hernia. A total of 217 patients were regularly followed-up at the department of paediatric surgery in Dhaka Medical College Hospital (DMCH) and Bangabandhu Sheikh Mujib Medical University (BSMMU) from February 1995 to June 2001 in order to determine if contralateral hernia developed after unilateral herniotomy. The overall incidence of contralateral manifestations was 6.45%. The average incidence for contralateral hernia in infants upto 1 year was 11.68%. However, the incidence fell significantly in older children. With such low incidence of contralateral hernia after unilateral herniotomy, the authors do not feel to recommend contralateral exploration for unilateral inguinal hernia.   DOI: http://dx.doi.org/10.3329/taj.v14i2.8385 TAJ 2001; 14(2): 53-55

Sign in / Sign up

Export Citation Format

Share Document