Lee Dong-Gi, Lee Young-Suk, Park Kwan Hyun, Baek Minki
Department of Urology, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
Exp Ther Med. 2015 Feb;9(2):421-424. doi: 10.3892/etm.2014.2098. Epub 2014 Dec 1.
Concurrent contralateral inguinal exploration in children with unilateral hernia or hydrocele is a subject of debate. The aim of the present study was to investigate the incidence of contralateral patent processus vaginalis (CPPV) using transinguinal laparoscopy (inguinoscopy). In addition, the risk factors of CPPV were evaluated in order to facilitate the selection of appropriate candidates for contralateral examination. A total of 119 patients who presented with unilateral hydrocele, inguinal hernia or cryptorchidism between 2001 and 2008 underwent inguinoscopy during the ipsilateral surgery. All data were collected prospectively. The incidence of CPPV was investigated and the risk factors affecting the presence of CPPV were analyzed. Among these patients, 29 individuals (24.4%) had CPPV confirmed by inguinoscopy. No surgical complications were observed during the inguinoscopy. Cases with suspicious ultrasound findings were at a higher risk of CPPV than cases with normal findings (odds ratio, 13.800; P=0.004). A history of contralateral disease was also found to be a significant risk factor (odds ratio, 4.008; P=0.019). The present study identified that the significant risk factors for CPPV were suspicious findings on ultrasound examination and a history of contralateral disease. Therefore, it is concluded that performing inguinoscopy in children with these risk factors is beneficial.
对单侧疝或鞘膜积液患儿同期进行对侧腹股沟探查是一个存在争议的问题。本研究的目的是使用经腹股沟腹腔镜检查(腹股沟镜检查)来调查对侧鞘突未闭(CPPV)的发生率。此外,评估CPPV的危险因素以便于选择合适的对侧检查对象。2001年至2008年间,共有119例单侧鞘膜积液、腹股沟疝或隐睾患儿在同侧手术期间接受了腹股沟镜检查。所有数据均前瞻性收集。调查CPPV的发生率并分析影响CPPV存在的危险因素。在这些患者中,29例(24.4%)经腹股沟镜检查确诊为CPPV。腹股沟镜检查期间未观察到手术并发症。超声检查结果可疑的病例发生CPPV的风险高于检查结果正常的病例(优势比,13.800;P=0.004)。对侧疾病史也被发现是一个显著的危险因素(优势比,4.008;P=0.019)。本研究确定CPPV的显著危险因素是超声检查可疑结果和对侧疾病史。因此,得出结论,对有这些危险因素的儿童进行腹股沟镜检查是有益的。