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Prediction of contralateral inguinal hernias in children: a prospective study of 357 unilateral inguinal hernias
M Hoshino1, K Sugito, H Kawashima
1Department of Pediatric Surgery, Nihon University School of Medicine, 30-1, Ohyaguchikami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.
Insights
A pre-operative risk score and hernia side effectively predict contralateral inguinal hernias in children. This study validates a scoring system for improved surgical planning and patient outcomes in pediatric inguinal hernia cases.
Area of Science:
- Pediatric Surgery
- Hernia Surgery
- Clinical Risk Prediction
Background:
- Unilateral inguinal hernias are common in children.
- Predicting contralateral inguinal hernias is crucial for surgical planning.
- A pre-operative risk scoring system was previously established.
Purpose of the Study:
- To verify the clinical utility of a pre-operative risk scoring system.
- To assess the predictive accuracy for contralateral inguinal hernias in pediatric patients.
- To identify key factors influencing contralateral hernia development.
Main Methods:
- Prospective study of 372 children undergoing unilateral inguinal hernia repair (2006-2009).
- Data collected: gender, age, birth weight, initial operation side, pre-operative risk score.
- 36-month follow-up; forward multiple logistic regression analysis used.
Main Results:
- 23 patients (6.4%) developed a contralateral hernia within 36 months.
- Left-sided hernias significantly increased contralateral hernia risk (OR=5.5, p=0.023).
- Pre-operative risk score was significantly higher in patients with contralateral hernias (p=0.024).
Conclusions:
- The pre-operative risk scoring system is useful for predicting contralateral inguinal hernias.
- Initial hernia side is a significant predictor alongside the risk score.
- This combined approach enhances prediction accuracy in pediatric inguinal hernia cases.
Purpose:
Previously, we established a pre-operative risk scoring system to predict contralateral inguinal hernia in children with unilateral inguinal hernias. The current study aimed to verify the usefulness of our pre-operative scoring system.
Methods:
This was a prospective study of patients undergoing unilateral inguinal hernia repair from 2006 to 2009 at a single institution. Gender, age at initial operation, birth weight, initial operation side, and the pre-operative risk score were recorded. We analyzed the incidence of contralateral inguinal hernia, risk factors, and the usefulness of our pre-operative risk scoring system. The follow-up period was 36 months. We used forward multiple logistic regression analysis to predict contralateral hernia.
Results:
Of the 372 patients who underwent unilateral hernia repair, 357 (96.0 %) were completely followed-up for 36 months, and 23 patients (6.4 %) developed a contralateral hernia. Left-sided hernia (OR = 5.5, 95 %, CI = 1.3-24.3, p = 0.023) was associated with an increased risk of contralateral hernia. The following covariates were not associated with contralateral hernia development: gender (p = 0.702), age (p = 0.215), and birth weight (p = 0.301). The pre-operative risk score (cut-off point = 4.5) of the patients with a contralateral hernia was significantly higher, compared with the patients without a contralateral hernia using the area under the receiver operating characteristic curve (p = 0.024).
Conclusions:
Using multivariate analysis, we confirmed usefulness of our pre-operative scoring system and initial side of the inguinal hernia, together, for the prediction of contralateral inguinal hernia in children.
