WOFAPS 2025 8th World Congress of Pediatric Surgery

Domingas Atouguia, Silviana Ribeiro, Tiago Tuna, Miguel Campos, Angélica Osório Rodrigues

Centro Hospitalar Universitário São João, Porto, Portugal

Purpose:

Laparoscopic correction of pediatric inguinal hernia (LIH) remains controversial, with the main argument in favor being the prevention of metachronous inguinal hernia (MH) by simultaneous closure of the contralateral persistent peritoneo-vaginal duct (PPV). A review of the literature and evaluation of the incidence/characterization of MH cases in patients operated on unilateral inguinal hernia (IH) in the first year of life were conducted.

Method:

All children <1 year old who underwent open repair of unilateral HI in a tertiary center between January 2010/December 2012 were evaluated for MH over a follow-up period 12-14 years. Data were obtained through clinical records. Exclusion criteria: HI >=1 year; LIH; bilateral IH; homolateral/contralateral cryptorchidism; recurrent IH and unavailability of data in the clinical record. Statistical analysis was performed with SPSS®.

Results:

A total of 168 patients were included, of whom 17 developed MH (incidence rate: 10.12%; 95% CI: 5.65-14.59%). Of these, 12 were male and 5 were female; 10 had right-sided hernia and 7 had left-sided hernia, with a mean age at first intervention of 3.24 months. No significant association was found between MH and age at intervention (p=0.075), prematurity (p=1), sex (p=0.548) or laterality (p=0.700).

Conclusion:

In the literature, incidences of PPV between 20%-50% are reported, so not all PPV will be HI and their closure will be a likely form of overtreatment. According to our results, ten IHL with contralateral PPV closure will be necessary to avoid a MH, so the need for PPV closure remains controversial.