Draus John M, Kamel Sarah, Seims Aaron, Rescorla Frederick J
Kentucky Children's Hospital and the Division of Pediatric Surgery, University of Kentucky College of Medicine, Lexington, Kentucky 40536-0298, USA.
Am Surg. 2011 Nov;77(11):1463-6.
Our objective was to determine the accuracy of laparoscopic evaluation to detect a contralateral patent processus vaginalis (CPPV) at initial presentation for inguinal hernia (IH) repair and the rate of CPPV relative to age, sex, and initial hernia side. We performed a 5-year retrospective review of 1580 pediatric patients with unilateral IH in which surgeons selectively used laparoscopy to evaluate for a CPPV. There were 1205 boys and 303 girls; 980 (65%) presented with right IH (RIH) and 528 (35%) with left IH (LIH). Laparoscopic evaluation was performed in 459 (47%) patients presenting with RIH and 225 (43%) patients presenting with LIH. Laparoscopic evaluation was positive for CPPV in 32 per cent of patients with RIH and 42 per cent of patients with LIH (P = 0.0168). CPPV was associated with prematurity (P = 0.0003) and age younger than 6 months (P = 0.0001) but not with sex (P = 0.55). The future contralateral occurrence rate was 1.6 per cent and recurrence rate 0.2 per cent. This study supports the accuracy of CPPV evaluation by laparoscopy. Although the rate of CPPV decreases after 6 months of age, girls older than 2 years of age have a significantly higher rate of CPPV than boys, supporting laparoscopic evaluation in older girls.
我们的目的是确定在初次就诊时行腹股沟疝（IH）修补术时，腹腔镜评估检测对侧鞘状突未闭（CPPV）的准确性，以及CPPV相对于年龄、性别和初次疝侧的发生率。我们对1580例单侧IH患儿进行了为期5年的回顾性研究，外科医生选择性地使用腹腔镜评估CPPV。其中有1205名男孩和303名女孩；980例（65%）为右侧腹股沟疝（RIH），528例（35%）为左侧腹股沟疝（LIH）。459例（47%）RIH患儿和225例（43%）LIH患儿接受了腹腔镜评估。腹腔镜评估显示，32%的RIH患儿和42%的LIH患儿存在CPPV（P = 0.0168）。CPPV与早产（P = 0.0003）和6个月以下年龄（P = 0.0001）相关，但与性别无关（P = 0.55）。未来对侧发生率为1.6%，复发率为0.2%。本研究支持腹腔镜评估CPPV的准确性。尽管6个月龄后CPPV发生率降低，但2岁以上女孩的CPPV发生率明显高于男孩, 支持对大龄女孩进行腹腔镜评估.
