Incidence of metachronous contralateral inguinal hernias in children following unilateral repair — A meta-analysis of prospective studies

Abstract Purpose The objective of this review was to systematically evaluate the incidence of a metachronous contralateral inguinal hernia (MCIH) in children with unilateral inguinal hernia and therefore to propose or to reject routine contralateral groin exploration. Methods Electronic searches res...

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Bibliographic Details
Published in:Journal of pediatric surgery 2015-12, Vol.50 (12), p.2147-2154
Main Authors: Wenk, Kathrin, Sick, Beate, Sasse, Tom, Moehrlen, Ueli, Meuli, Martin, Vuille-dit-Bille, Raphael N
Format: Article
Language:English
Subjects:
Child
Contralateral
Hernia, Inguinal - complications
Hernia, Inguinal - surgery
Humans
Incidence
Infant
Inguinal hernia
Metachronous
Pediatrics
Risk Factors
Surgery
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Summary:Abstract Purpose The objective of this review was to systematically evaluate the incidence of a metachronous contralateral inguinal hernia (MCIH) in children with unilateral inguinal hernia and therefore to propose or to reject routine contralateral groin exploration. Methods Electronic searches restricted to prospective studies with a minimal follow-up of 1 year included MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. Results Six studies involving 1669 children were included. Overall MCIH was 6% (95% CI from 4% to 8%). The odds for MCIH development were significantly larger in children with an initial left-sided hernia (OR 2.66 with 95% CI from 1.56 to 4.53) and in children with open contralateral processus vaginalis (CPV) (OR 4.17 with 95% CI from 1.25 to 13.9). Conclusions The overall incidence of MCIH following unilateral inguinal hernia repair in children is 6%. Initial left-sided hernia (8.5%) and open CPV (13.8%) are risk factors for MCIH development. Female gender (8.2%) and younger age (< 1 year) (6.9%) non-significantly increase the risk of MCIH.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2015.08.056