Preliminary study of contralateral occult inguinal indirect hernia in male children by laparoscopy

Objective To evaluate the prevalence and incidence of contralateral occult inguinal indirect hernia (OPPV) in male children by laparoscopy.Methods A 5-year retrospective review was conducted for 2596 male patients undergoing unilateral inguinal laparoscopic herniorraphy (LH) from January 2008 to June 2013.Results Among them,44.65％ (1 159/2 596) had OPPV in contralateral inguinal groin while 4.31％ (50/1 159) developed contralareal indirect hernia.Laparoscopic evaluation was positive for right-sided OPPV in 48.89％ (420/859) and left-sided lesion in 42.54％ (739/1 737)(x2 =9.38,P＜0.01).Left-sided indirect hernia (RR =1.15) was associated with an elevated risk of contralateral OPPV.OPPV was diagnosed in 40.65％ (163/401) of patients aged under 1 year and the future contralateral occurrence rate was 6.75％ (11/163).The highest prevalence of 59.53％ (534/897) and the lowest incidence of 1.87％ (10/534) of OPPV were found in those patients aged under 2 years respectively.Laparoscopic evaluation was positive for OPPV in 40.41％ of patients aged 2-6 years.And 5.28％ patients developed contralateral indirect hernia.The lowest prevalence of 23.06％ (83/360) and the highest incidence of 10.84％ (9/83) of OPPV were found in those aged 6-16 years respectively.And 80.00％ (40/50) patients with contralateral indirect hernia resulting from OPPV had the causes of respiratory infections and diarrheal diseases while 20.00％ (10/50) did not.The future recurrence rate was 0.08 ％ (2/2 596).Conclusions Laparoscopic exploration should be routinely performed for pediatric patients of all ages because of a high prevalence and incidence of contralateral OPPV.Especially,LH should be actively performed in patients aged over 2 year because of a high incidence of contralateral OPPV. Key words: Groin; Laparoscopy;  Prevalence;  Incidence