Abstract
Purpose: To determine the incidence of metachronous contralateral inguinal hernia and the indications for prophylactic surgery, we examined the morphology of contralateral patent process vaginalis (PPV) at laparoscopic percutaneous extraperitoneal closure (LPEC). Methods: Two hundred forty-three patients (mean age 3.9 years old) were reviewed for retrospective evaluation. We classified these patients into a PPV-positive group and PPV-negative group. Result One hundred twelve of 228 patients (49%) who were diagnosed hemilateral inguinal hernia preoperatively demonstrated contralateral PPV at surgery. The mean diameter of the symptomatic internal ring was significantly larger than that on the contralateral side (8.9±3.2mm and4.8±2.9mm respectively). There was one case of metachronous contralateral inguinal hernia. There was no significant difference between the PPV-positive group and PPV-negative group in patient's sexuality, median age, or laterality of primary lesion. Ninety-six percent of symptomatic internal inguinal rings were larger than 4mm, while sixty-three percent of contralateral internal inguinal rings were larger than 4mm, comprising 31% of all patients diagnosed as having hemilateral inguinal hernia preoperatively. Conclusions: About fifty percent of preoperatively diagnosed cases of hemilateral inguinal hernia were demonstrated to be PPV-positive at surgery. The existence of contralateral PPV could not be predicted by sexuality, age or laterality of primary lesion. Thirty-one percent of preoperatively diagnosed cases of hemilateral inguinal hernia demonstrated contralateral PPV larger than 4mm. We consider that these cases had potential risk of metachronous contralateral hernia.
