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A study of contralateral persistent processus vaginalis in laparoscopic hernia repair in children
1Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Insights
In pediatric inguinal hernia repair, the size of the hernia opening and contralateral persistent processus vaginalis (CPPV) did not correlate with patient age. CPPV was more frequent in left hernias and decreased with age.
Area of Science:
- Pediatric Surgery
- Laparoscopic Surgery
- Hernia Repair
Background:
- Laparoscopy allows intra-abdominal visualization of hernias and contralateral persistent processus vaginalis (CPPV).
- Understanding the characteristics of CPPV is crucial for surgical planning and outcomes in pediatric inguinal hernia repair.
Purpose of the Study:
- To investigate the diameter of the opening of inguinal hernias and CPPV in pediatric patients with unilateral inguinal hernias.
- To evaluate the correlation between these diameters and patient age.
Main Methods:
- Retrospective evaluation of 569 pediatric patients undergoing laparoscopic repair of unilateral inguinal hernia.
- Measurement of the diameter of the hernia opening and CPPV.
- Statistical analysis using Pearson correlation and linear-by-linear association.
Main Results:
- CPPV was observed in 58.0% of patients, with a higher incidence in left hernias (62.8%) compared to right hernias (54.0%).
- The mean diameter of the hernia opening (11.2 mm) was significantly larger than that of CPPV (6.1 mm).
- The incidence of CPPV decreased with age, from 77.2% in infants to 46.6% in children aged 6 years and older. Neither hernia opening diameter nor CPPV diameter correlated with age.
Conclusions:
- Hernia and CPPV opening diameters in pediatric unilateral inguinal hernias are not age-dependent.
- CPPV is more prevalent in left-sided hernias and its incidence declines with increasing age.
- Laparoscopic assessment provides valuable data on hernia and CPPV dimensions, aiding in understanding their relationship with age.
Purpose:
The introduction of laparoscopy for hernia repair permits intra-abdominal observation of a hernia and contralateral persistent processus vaginalis (CPPV). The current study's aim was to investigate the diameter of opening of an inguinal hernia and CPPV in patients with unilateral inguinal hernia, and to evaluate their correlation with age.
Methods:
From September 2012 to August 2017, 569 pediatric patients underwent laparoscopic repair of unilateral inguinal hernia. We retrospectively evaluated the size of the hernia and CPPV by measuring the diameter of opening. Pearson correlation analysis and linear-by-linear association were used in the statistical analysis.
Results:
The median age at operation was 32.4 months (range 0.2-219 months). CPPV was observed in 330 patients (58.0%), and its incidence was significantly higher in patients with left inguinal hernias than in those with right inguinal hernias (62.8 versus 54.0%, p < 0.001). The mean diameter of opening for the hernias was significantly larger than that for CPPV (11.2 ± 3.1 vs. 6.1 ± 2.5 mm, p < 0.001). The incidence of CPPV gradually decreased from 77.2% in infants to 46.6% in the oldest age group (≥ 6 years) (p trend < 0.001). The diameter of the opening of a hernia was not correlated with increasing age, and the diameter of the opening of a CPPV was not correlated with increasing age, as well.
Conclusion:
The diameters of a hernia and CPPV were identified in the current study, and the diameter was not correlated with increasing age. The incidence of CPPV was more common in patients with left inguinal hernias than in those with right inguinal hernias, and it gradually decreased with increasing age.
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