American Academy of Pediatrics Section on Surgery hernia survey revisited

Mara B. Antonoff, Nathaniel S. Kreykes, Daniel A Saltzman, Robert D Acton

Research output: Contribution to journalReview articlepeer-review

82 Scopus citations

Abstract

Background: The aim of the study was to describe current treatment and trends in surgical management of pediatric inguinal hernias (IHs), specifically contralateral exploration. Methods: Surveys were sent to 599 Surgical Section members. Questions paralleled the 1993 American Academy of Pediatrics survey and addressed recent controversial topics. Statistical analysis by χ2 was performed. Results: Three hundred ninety-five (66%) surveys returned. For full-term boys with reducible IH, 79% (82%) repair electively, regardless of age or weight. For full-term girls with reducible ovary, 49% (27%) repair electively, 36% (59%) next available slot, 5% (10%) emergently (P <. 01). In former premature infants, 53% (65%) repair reducible IH when convenient, regardless of age. For unilaterally presenting IH, 44% (65%) routinely explore contralateral groins in boys 2 years or younger (P <. 01); 47% (84%) routinely explore girls 4 years or younger (P <. 01). No significant association between routine exploration patterns and years in practice, region of country, or training program affiliation was found. Laparoscopic evaluation for contralateral IH was reported by 37% (6%), (P <. 01) 1993 results italicized. Conclusion: Reports of routine contralateral inguinal exploration had absolute decreases of 21% for boys 2 years or younger, 37% for girls 4 years or younger. There has been a shift toward elective repair for girls with reducible ovaries. Use of laparoscopy for diagnostic contralateral evaluation has increased dramatically.

Original languageEnglish (US)
Pages (from-to)1009-1014
Number of pages6
JournalJournal of Pediatric Surgery
Volume40
Issue number6
DOIs
StatePublished - Jun 1 2005

Keywords

  • Anemia
  • Contralateral
  • Hydrocele
  • Infant
  • Inguinal hernia
  • Laparoscopy
  • Postoperative pain
  • Questionnaires
  • Surgery

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