Incidence of contralateral patent processus vaginalis in relation to age at laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia

Abstract

Introduction: Laparoscopic percutaneous extraperitoneal closure (LPEC) allows the surgeon to look for contralateral patent processus vaginalis (CPPV) directly. We investigated the incidence of CPPV in relation to age at LPEC.

Methods: Following Institutional Review Board approval, 1232 patients ranging in age from 2 months old to 15 years old (median 4.7 years), who underwent LPEC, were investigated retrospectively. Patients were divided into five groups based on their age at surgery: younger than 1, 1-2, 2-4, 4-6 years, and older than 6 years. The incidence of CPPV being detected by preoperative ultrasonography or laparoscopy was compared among these groups. Statistical analyses were performed using the Chi-square test or Cochran-Armitage trend test, and p < 0.05 was considered significant.

Results: The incidence of CPPV detected by ultrasonography decreased as the age increased (p < 0.0001), whereas the incidence of CPPV newly revealed by laparoscopy increased as age increased (p = 0.0001). There were no significant differences in the incidence of CPPV in patients with unilateral hernia among the five age groups (p = 0.74).

Conclusions: These results showed that the incidence of CPPV in patients with unilateral inguinal hernia did not change in relation to their age.

Keywords: Contralateral patent processus vaginalis; Laparoscopic percutaneous extraperitoneal closure; Pediatric inguinal hernia.