Related Experiment Video
Updated: Jun 1, 2026
03:57
Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
Published on: July 8, 2025
Systematic review for paediatric metachronous contralateral inguinal hernia: a decreasing concern
Ramesh M Nataraja1, Anies A Mahomed
1Department of Paediatric Surgery, Royal Alexandra Hospital for Sick Children, Brighton, UK. nataraja@doctors.org.uk
Pediatric Surgery International
|May 24, 2011
Summary
Routine contralateral exploration for pediatric unilateral inguinal hernias is not supported by evidence. Infants under 6 months and those with left-sided hernias have higher risks of metachronous contralateral inguinal hernia (MCIH).
Area of Science:
- Pediatric Surgery
- Hernia Repair
- Clinical Evidence Synthesis
Background:
- Unilateral inguinal hernias in children often raise concerns about developing a metachronous contralateral inguinal hernia (MCIH).
- This potential for a second surgery necessitates evaluating the benefits of routine contralateral exploration.
Purpose of the Study:
- To systematically review current evidence on routine contralateral exploration for pediatric unilateral inguinal hernias.
- To identify specific patient groups at higher risk for MCIH.
Main Methods:
- A comprehensive literature review was conducted using broad search terms.
- Inclusion criteria focused on studies of pediatric unilateral inguinal hernia repair without routine contralateral exploration.
- Statistical analysis included Chi-square tests and calculation of numbers needed to treat (NNT).
Main Results:
- Data from 61 studies involving 49,568 patients showed an overall MCIH risk of 5.76%.
- The NNT to prevent one MCIH through contralateral exploration is 18.
- Increased MCIH risk was observed in patients under 6 months (NNT 9) and those with left-sided hernias (NNT 9).
Conclusions:
- Insufficient evidence supports routine contralateral inguinal exploration for all pediatric unilateral inguinal hernias.
- Consideration for contralateral exploration should involve parental discussion for infants <6 months and those with left-sided hernias, weighing potential benefits against risks.
