Kathrin Wenk1, Beate Sick2, Tom Sasse3, Ueli Moehrlen4, Martin Meuli4, Raphael N Vuille-dit-Bille5. 1. Emergency Department, Hospital Baden, Baden, Switzerland. 2. Epidemiology, Biostatistics, and Prevention Institute (EBPI) at the University of Zurich, Zürich, Switzerland. 3. University of Zurich, Zürich, Switzerland. 4. Pediatric Surgery, University Children's Hospital of Zurich, Zürich, Switzerland. 5. Pediatric Surgery, University Children's Hospital of Zurich, Zürich, Switzerland. Electronic address: rnvuille@gmail.com.
Abstract
PURPOSE: The objective of this review was to systematically evaluate the incidence of a metachronous contralateral inguinal hernia (MCIH) in children with unilateral inguinal hernia and therefore to propose or to reject routine contralateral groin exploration. METHODS: Electronic searches restricted to prospective studies with a minimal follow-up of 1year included MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. RESULTS: Six studies involving 1669 children were included. Overall MCIH was 6% (95% CI from 4% to 8%). The odds for MCIH development were significantly larger in children with an initial left-sided hernia (OR 2.66 with 95% CI from 1.56 to 4.53) and in children with open contralateral processus vaginalis (CPV) (OR 4.17 with 95% CI from 1.25 to 13.9). CONCLUSIONS: The overall incidence of MCIH following unilateral inguinal hernia repair in children is 6%. Initial left-sided hernia (8.5%) and open CPV (13.8%) are risk factors for MCIH development. Female gender (8.2%) and younger age (<1year) (6.9%) non-significantly increase the risk of MCIH.
PURPOSE: The objective of this review was to systematically evaluate the incidence of a metachronous contralateral inguinal hernia (MCIH) in children with unilateral inguinal hernia and therefore to propose or to reject routine contralateral groin exploration. METHODS: Electronic searches restricted to prospective studies with a minimal follow-up of 1year included MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. RESULTS: Six studies involving 1669 children were included. Overall MCIH was 6% (95% CI from 4% to 8%). The odds for MCIH development were significantly larger in children with an initial left-sided hernia (OR 2.66 with 95% CI from 1.56 to 4.53) and in children with open contralateral processus vaginalis (CPV) (OR 4.17 with 95% CI from 1.25 to 13.9). CONCLUSIONS: The overall incidence of MCIH following unilateral inguinal hernia repair in children is 6%. Initial left-sided hernia (8.5%) and open CPV (13.8%) are risk factors for MCIH development. Female gender (8.2%) and younger age (<1year) (6.9%) non-significantly increase the risk of MCIH.
Authors: Ralph F Staerkle; Laura C Guglielmetti; Isabella N Bielicki; Stefan Gaukel; Giovanni Frongia; Sarah Hilton; Lukas Fink; Raphael N Vuille-Dit-Bille Journal: Medicine (Baltimore) Date: 2020-07-31 Impact factor: 1.817