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对于在出生后最初几个月接受腹股沟疝修补术的早产女婴,对侧腹股沟探查是否必要?

Is contralateral inguinal exploration necessary in preterm girls undergoing inguinal hernia repair during the first months of life?

作者信息

Demouron Marion, Delforge Xavier, Buisson Philippe, Hamzy Mounia, Klein Céline, Haraux Elodie

机构信息

Department of Pediatric Surgery, Amiens University Hospital, Avenue Laennec-Salouël, 80054, Amiens Cedex 1, France.

PeriTox-UMI 01, UFR de Médecine, Jules Verne University of Picardy, 80054, Amiens, France.

出版信息

Pediatr Surg Int. 2018 Nov;34(11):1151-1155. doi: 10.1007/s00383-018-4334-1. Epub 2018 Aug 17.

Abstract

BACKGROUND

To assess the need for contralateral surgical exploration in preterm girls with symptomatic unilateral inguinal hernia.

METHODS

The medical data of girls operated for inguinal hernia between 2004 and 2016 in a single pediatric surgery center were retrospectively collected. Preterm girls operated for unilateral hernia before 6 months of life were selected (55/517 cases) to assess the incidence and risk factors for contralateral metachronous inguinal hernia (CMIH).

RESULTS

CMIH was observed in 7% of cases (4 girls with a right inguinal hernia in 3 cases) at a mean age of 4.2 years. Only one case occurred early (3 months). Birth weight and term were comparable (1674 ± 620 g and 32 ± 5 WA without CMIH vs. 1694 ± 582 g and 33 ± 3 WA with CMIH).

CONCLUSION

Contralateral inguinal hernia is very rare and generally occurs several years after inguinal repair surgery in preterm girls, which should encourage practitioners to follow these children throughout childhood for the subsequent development of inguinal hernia. This study did not find any arguments in favor of systematic contralateral exploration in preterm girls.

摘要

背景

评估有症状的单侧腹股沟疝早产女婴对侧手术探查的必要性。

方法

回顾性收集2004年至2016年在单一儿科手术中心接受腹股沟疝手术的女孩的医疗数据。选择出生后6个月内接受单侧疝手术的早产女婴(55/517例),以评估对侧迟发性腹股沟疝(CMIH)的发生率和危险因素。

结果

7%的病例观察到CMIH(3例中有4名右侧腹股沟疝女孩),平均年龄4.2岁。仅1例发生较早(3个月)。出生体重和孕周相当(无CMIH者为1674±620g和32±5周龄,有CMIH者为1694±582g和33±3周龄)。

结论

对侧腹股沟疝非常罕见,通常发生在早产女婴腹股沟修补手术后数年,这应促使医生在儿童期全程随访这些儿童,以观察腹股沟疝的后续发展情况。本研究未发现支持对早产女婴进行系统性对侧探查的依据。

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