Risk factors for metachronous contralateral inguinal hernia after laparoscopic percutaneous extraperitoneal closure for unilateral inguinal hernia in children
Risk factors for metachronous contralateral inguinal hernia after laparoscopic percutaneous extraperitoneal closure for unilateral inguinal hernia in children
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DOI：
10.1007/s00595-022-02480-0
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发表时间：
2022-02-24
期刊：
影响因子：
2.5
通讯作者：
Shimada, Mitsuo
中科院分区：
文献类型：
--
作者：
Mori, Hiroki;Ishibashi, Hiroki;Shimada, Mitsuo
目的我们使用腹腔镜经皮腹膜外闭合术（LPEC）作为小儿腹股沟疝的标准手术方法。尽管在第一次LPEC时判断没有对侧迷走突（PPV），但我们经历了5例异时性对侧腹股沟疝（MCH）的发展，因此我们报告了其特征，包括预测因素。方法对2005年至2019年我科收治的1277例小儿腹股沟疝采用LPEC法进行治疗。其中，374例患者接受了单侧LPEC，我们比较了5例MCH发作患者和369例无MCH发作患者。检查项目包括性别、年龄、是否存在低出生体重、首发侧和对侧腹股沟内环分类。结果两组患者的性别、年龄、首发侧及对侧腹股沟内环分型差异无统计学意义。低出生体重儿在患有MCH的人群中比在没有MCH的人群中更常见。结论低出生体重是LPEC治疗小儿腹股沟疝后对侧发病的唯一预测因素。因此，对于上述单侧LPEC病例，应考虑由于后天因素而非先天因素导致LPEC后对侧发病的可能性。
Purposes We use the laparoscopic percutaneous extraperitoneal closure (LPEC) method as the standard procedure for pediatric inguinal hernia. Despite judging there to be no contralateral patent processus vaginalis (PPV) at the time of the first LPEC, we experienced five cases in which metachronous contralateral inguinal hernia (MCH) developed, so we report the characteristics, including the predictors. Methods For pediatric inguinal hernia, the LPEC method was used in 1277 cases from 2005 to 2019 in our department. Of these, 374 patients underwent unilateral LPEC, and we compared the 5 patients with MCH onset and the 369 without MCH onset. The items to be examined were the gender, age, presence of a low birth weight, initial-onset side, and contralateral internal inguinal ring classification. Results There was no significant difference in the gender, age, initial-onset side, or contralateral internal inguinal ring classification between the two groups. Low-birth-weight infants were significantly more common among those with MCH than among those without MCH. Conclusions The only predictor of a contralateral onset after LPEC for pediatric inguinal hernia was a low birth weight. Therefore, for the above-mentioned unilateral LPEC cases, the possibility of a contralateral onset after LPEC due to acquired factors rather than congenital factors should be considered.