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J Pediatr Surg. 2006 May;41(5):980-6.

Six thousand three hundred sixty-one pediatric inguinal hernias: a 35-year review.

Author information

1
Division of General Surgery, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8. a_ein@istar.ca

Abstract

PURPOSE:

This study, by its mere size and uniformity (1 pediatric surgeon), aims to corroborate or refute the teachings and myths of the pediatric inguinal hernia.

METHODS:

From July 1969 to January 2004, 6361 infants and children with inguinal hernias were seen, operated on, and followed by the senior author. A retrospective survey of their charts was carried out to evaluate the demographics and clinical aspects of these patients. The hospital's research ethics board approved of this study.

RESULTS:

The ages ranged from premature to 18 years (mean age, 3.3 years) with a male-to female ratio of 5:1. There were 59% right, 29% left, and 12% bilateral hernias (almost all indirect). Hydroceles were found in 19%. Incarceration occurred in 12%. A modified Ferguson repair was used. An opposite-side hernia developed in 5%, 95% within the first 5 years, and was not sex or age specific. There were 1.2% recurrences, 96% within 5 years. Thirteen percent had ventriculo-peritoneal shunts, 1.2% wound infections, and 0.3% testicular atrophy. There were no postoperative deaths. One percent had a documented hernia disappearance.

CONCLUSIONS:

Three of our results have not corresponded with previous teachings and myths: (1) a hernia of a premature baby should be fixed sooner than later; (2) routine contralateral groin exploration is not indicated in any situation; and (3) teenage recurrence rate is 4 times greater than the overall series.

PMID:
16677897
DOI:
10.1016/j.jpedsurg.2006.01.020
[Indexed for MEDLINE]

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