Is contralateral exploration necessary in preterm infants with unilateral inguinal hernia?

Purpose: Contralateral inguinal exploration has been the preferred approach to preterm infants with unilateral inguinal hernia. There is no literature evidence to justify this. The aim of this prospective study is to analyze the incidence and to determine any risk factors for the development of contralateral metachronous hernia (MH) in the preterm when compared with term infants.

Methods: Preterm and term infants with unilateral inguinal hernia younger than 6 months who underwent surgery were included. Those infants who subsequently developed MH were analyzed.

Results: Two hundred sixty-six patients met the inclusion criteria. One hundred five were preterm and 161 were term. Ten preterm (10.31%) and 9 term infants (5.92%) presented subsequently with MH (P =.18). All but 1 were male. There was no relation between the side of hernia, presentation with incarceration, age at surgery, sex of the patient, and the development of MH. However, a trend toward a higher incidence of MH in very low birth weight and early gestational age preterms was noted.

Conclusion: There is no significant difference between the occurrence of MH in preterm when compared with term infants. Routine contralateral exploration in preterm infants with its associated risks is therefore not justified in unilateral hernia.