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The infantile inguinal hernia - a bilateral disease?
M G Schwöbel1, H Schramm, C A Gitzelmann
1Chirugische Klinik, Universitätskinderspital Zürich, Steinwiesstrasse 75, CH-8032 Zürich, Switzerland.
Pediatric Surgery International
|March 18, 1999
Summary
Routine contralateral exploration for unilateral inguinal hernias in infants is unnecessary. Most cases are unilateral, with only 5.7% requiring a second operation on the opposite side.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
Background:
- Controversy exists regarding routine contralateral exploration for unilateral inguinal hernias (IH) in infants.
- Historical data suggests a high incidence of contralateral hernias, influencing surgical practice.
Purpose of the Study:
- To evaluate the frequency of contralateral hernial development in infants under one year of age.
- To assess the validity of a selective surgical approach, operating only on the symptomatic side.
Main Methods:
- Retrospective review of medical records for 882 infants operated on for IH between 1984 and 1988.
- Follow-up of patients until December 1996 to identify contralateral hernial development.
Main Results:
- A second operation was needed on the contralateral side in 5.7% of cases.
- Premature male infants showed the highest incidence of contralateral hernial development (11.5%).
- The majority of infants (761/882) presented with unilateral IH.
Conclusions:
- Inguinal hernia in infants under one year is predominantly a unilateral disease.
- Routine exploration of the asymptomatic contralateral side is not routinely required for infants under one year of age.