Incidence of and Risk Factors for Pediatric Metachronous Contralateral Inguinal Hernia: Analysis of a 17-Year Nationwide Database in Taiwan

Previous prospective, retrospective, and meta-analysis studies revealed that the overall incidence of metachronous contralateral inguinal hernia (MCIH) ranges from 5.76% to 7.3%, but long-term follow-up postoperative data are scant. We identified the incidence and risk factors of MCIH in pediatric p...

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Published in:PloS one 2016-09, Vol.11 (9), p.e0163278-e0163278
Main Authors: Lee, Cheng-Hung, Chen, Yun, Cheng, Chi-Fu, Yao, Chao-Lin, Wu, Jin-Chia, Yin, Wen-Yao, Chen, Jian-Han
Format: Article
Language:English
Subjects:
Abdomen
Age
Body weight
Buddhism
Child health
Codes
Diagnostic systems
Emergency medical care
Exploration
Girls
Health insurance
Hernia
Hernias
Hospitals
Incidence
Inguinal hernia
Insurance
Laparoscopy
Medical diagnosis
Medical research
Medicine
Medicine and Health Sciences
Meta-analysis
National health insurance
Patients
Pediatrics
People and Places
Premature birth
Risk analysis
Risk factors
Social Sciences
Surgery
Surgical outcomes
Systematic review
Ventriculoperitoneal shunt
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Chen, Yun
Cheng, Chi-Fu
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Yin, Wen-Yao
Chen, Jian-Han
description Previous prospective, retrospective, and meta-analysis studies revealed that the overall incidence of metachronous contralateral inguinal hernia (MCIH) ranges from 5.76% to 7.3%, but long-term follow-up postoperative data are scant. We identified the incidence and risk factors of MCIH in pediatric patients during the follow-up using the Taiwan National Health Insurance Research Database (NHIRD). Between 1996/01/01 and 2008/12/31, all pediatric patients with primary unilateral inguinal hernia repair who were born after 1996/01/01 were collected via ICD-9 diagnostic and procedure codes recorded in NHIRD. Patients with another operation during the same admission, complicated hernia, or laparoscopic procedure were excluded. Several reported risk factors, including age, sex, preterm birth, low body weight, and previous ventriculoperitoneal shunt placement, were used for analysis. The primary endpoint was the repairmen of MCIH following the initial surgery. All patients were followed until 2013/12/31 or withdrawal from national health insurance. A total of 31,100 pediatric patients underwent unilateral inguinal hernia repair, and 111.76 months of median follow-up data were collected. The overall rate of MCIH was 12.3%. Among the 31,100 patients who had the hernia repair, 63.6% had MCIH within 2 years and 91.5% had MCIH within 5 years. After initial surgery, the incidence of MCIH gradually and significantly decreased with age up to approximately 6 years. Multivariable analysis showed that age
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We identified the incidence and risk factors of MCIH in pediatric patients during the follow-up using the Taiwan National Health Insurance Research Database (NHIRD). Between 1996/01/01 and 2008/12/31, all pediatric patients with primary unilateral inguinal hernia repair who were born after 1996/01/01 were collected via ICD-9 diagnostic and procedure codes recorded in NHIRD. Patients with another operation during the same admission, complicated hernia, or laparoscopic procedure were excluded. Several reported risk factors, including age, sex, preterm birth, low body weight, and previous ventriculoperitoneal shunt placement, were used for analysis. The primary endpoint was the repairmen of MCIH following the initial surgery. All patients were followed until 2013/12/31 or withdrawal from national health insurance. A total of 31,100 pediatric patients underwent unilateral inguinal hernia repair, and 111.76 months of median follow-up data were collected. The overall rate of MCIH was 12.3%. Among the 31,100 patients who had the hernia repair, 63.6% had MCIH within 2 years and 91.5% had MCIH within 5 years. After initial surgery, the incidence of MCIH gradually and significantly decreased with age up to approximately 6 years. Multivariable analysis showed that age &lt;4 y and girls were risk factors for subsequent MCIH. After 17 years of follow-up, the overall MCIH rate was 12.3%, and 91.7% of patients needed repair for MCIH within the first 5 years after initial surgery. Age &lt;4 years and girls were risk factors for MCIH. 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We identified the incidence and risk factors of MCIH in pediatric patients during the follow-up using the Taiwan National Health Insurance Research Database (NHIRD). Between 1996/01/01 and 2008/12/31, all pediatric patients with primary unilateral inguinal hernia repair who were born after 1996/01/01 were collected via ICD-9 diagnostic and procedure codes recorded in NHIRD. Patients with another operation during the same admission, complicated hernia, or laparoscopic procedure were excluded. Several reported risk factors, including age, sex, preterm birth, low body weight, and previous ventriculoperitoneal shunt placement, were used for analysis. The primary endpoint was the repairmen of MCIH following the initial surgery. All patients were followed until 2013/12/31 or withdrawal from national health insurance. A total of 31,100 pediatric patients underwent unilateral inguinal hernia repair, and 111.76 months of median follow-up data were collected. The overall rate of MCIH was 12.3%. Among the 31,100 patients who had the hernia repair, 63.6% had MCIH within 2 years and 91.5% had MCIH within 5 years. After initial surgery, the incidence of MCIH gradually and significantly decreased with age up to approximately 6 years. Multivariable analysis showed that age &lt;4 y and girls were risk factors for subsequent MCIH. After 17 years of follow-up, the overall MCIH rate was 12.3%, and 91.7% of patients needed repair for MCIH within the first 5 years after initial surgery. Age &lt;4 years and girls were risk factors for MCIH. The contralateral exploration for inguinal hernia should be considered among these patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27684710</pmid><doi>10.1371/journal.pone.0163278</doi><tpages>e0163278</tpages><orcidid>https://orcid.org/0000-0001-7360-2238</orcidid><oa>free_for_read</oa></addata></record>
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source NCBI_PubMed Central（免费）; Publicly Available Content (ProQuest)
subjects Abdomen
Age
Body weight
Buddhism
Child health
Codes
Diagnostic systems
Emergency medical care
Exploration
Girls
Health insurance
Hernia
Hernias
Hospitals
Incidence
Inguinal hernia
Insurance
Laparoscopy
Medical diagnosis
Medical research
Medicine
Medicine and Health Sciences
Meta-analysis
National health insurance
Patients
Pediatrics
People and Places
Premature birth
Risk analysis
Risk factors
Social Sciences
Surgery
Surgical outcomes
Systematic review
Ventriculoperitoneal shunt
title Incidence of and Risk Factors for Pediatric Metachronous Contralateral Inguinal Hernia: Analysis of a 17-Year Nationwide Database in Taiwan
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