Patent Contralateral Processus Vaginalis in Infants and Children Is Herniotomy Justified ?
Objectives: Contralateral inguinal exploration in pediatric unilateral inguinal hernia has been an issue of debate. Controversy still exists on whether contralateral patent processus vaginalis (CPPV) is justifiable for herniotomy. This study was conducted to investigate the hypothesis that CPPV alwa...
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Published in | Oman medical journal Vol. 33; no. 6; pp. 481 - 485 |
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Main Author | |
Format | Journal Article |
Language | English |
Published |
Muscat - Oman
Oman Medical Specialty Board
01.11.2018
OMJ |
Subjects | |
Online Access | Get full text |
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Summary: | Objectives: Contralateral inguinal exploration in pediatric unilateral inguinal
hernia has been an issue of debate. Controversy still exists on whether contralateral
patent processus vaginalis (CPPV) is justifiable for herniotomy. This study was
conducted to investigate the hypothesis that CPPV always necessitates herniotomy.
Methods: This prospective study was conducted on 200 pediatric patients aged 2–120
months old. All patients clinically diagnosed with a unilateral inguinal hernia underwent
a clinical examination of both inguinoscrotal regions followed by ultrasonography to
elucidate CPPV in both sides. Herniotomy was then performed on the hernia site
with laparoscopic evaluation of CPPV. Contralateral herniotomy was performed in 44
patients with Chin’s type III CPPV while the rest were followed-up for three years to
detect the appearance of any contralateral inguinal hernia. Results: The current study
included 158 boys and 42 girls (ratio of 3.8:1.0). Hernia was more common on the
right side (n = 136) than the left side (n = 64). Bilateral herniotomy was performed on
44 patients with Chin’s type III CPPV, while the remaining 156 patients underwent
unilateral herniotomy. During the follow-up period, contralateral hernia appeared in
58 patients; the remaining 98 patients, proved to have CPPV did not complain of a
clinical hernia during that period. Conclusions: Inguinal herniotomy for CPPV
seems not to be necessary in all cases. This would decrease the use of anesthesia and
surgical morbidity in young infants and save hospital resources through avoidance of
unnecessary operations. |
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Bibliography: | OMJ.jpg Oman Medical Journal, Vol. 33, No. 6, Nov 2018: 481-485 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1999-768X 2070-5204 |
DOI: | 10.5001/omj.2018.89 |