{"id":{"repo_id":"aachen","oai_identifier":"oai:publications.rwth-aachen.de:62442"},"canonical_url":"https://search.dev.ndltd.org/etd/aachen/oai:publications.rwth-aachen.de:62442","repository":{"repo_id":"aachen","name":"RWTH Aachen University","base_url":"https://publications.rwth-aachen.de/oai2d"},"display":{"title":"Kontralaterale Leistenhernien im Kindes- und Jugendalter : gibt es Risikofaktoren für die Ausbildung einer kontralateralen Hernie? : Eine retrospektive Studie von 2000 bis 2002 und eine prospektive Auswertung aus dem Jahre 2003","abstract":"Since the operative management of inguinal hernia in children has developed a routine procedure, the treatment of the contralateral side in infancy and childhood is still discussed controversial. In general, unilateral herniotomy is the most spreaded and most accepted method this time. There only exist agreement between pro-side and opposite side about contralateral exploration that several risk factors predispose the development of an inguinal hernia. Although, the basic question can not really answered with contentment finally: Which child does develop a contralateral inguinal hernia and which child does not? Aim of this report is to determine the factors which can affect the incidence of contralateral hernias in infants and children and which can lead to a hernia in progress. The result should simplify the treatment of high risk patients in view of a decision for or against a bilateral exploration. In the surgical department of the RWTH Aachen there were primary operated on an inguinal hernia between january 2000 and december 2003 368 children ( 278 boys and 90 girls) in the age of 0 until 16 years old. 22 of these children have to undergo a contralateral treatment at a later moment. The data are statistically analyzed with the programme SAS with the variable p<0,05 as significant sign of the Wilcoxon-Test respectively the Kruskal-Wallis Test as well as the result of the Fisher-Test method. In 22 cases (6,0 %) of all 368 children the treatment of a contralateral hernia was necessary after first undergoing unilateral herniotomy. A significant tendency to develop a contralateral hernia in male and female patients can be found in relation to the age at the primary operation, the space of time between first and second operation, the choice of anaesthesia, the birth grown, the gestational age and the number of concomitant diseases. About 16 children (72,7%) develop an inguinal hernia on the opposite side during the first two months after initial treatment. There can now be established a significant effect between the space of time between primary and recurrent operative treatment and that especially during the two first postoperative months. The choice of anaesthesia is significant with p< 0,0318. In 274 cases (74,5%) was utilized an endotracheal anaesthesia. Low birth weight infants develop more often a contralateral inguinal hernia compared with higher weight infants. Another risk factor is the gestational age, in the largest case 42 weeks of pregnancy and in the minimum 26 weeks of pregnancy. At last, there exist 8 children (36,4%) with a contralateral inguinal hernia with a relevant number of concomitant disease, significant statistically. Bilateral exploration of contralateral inguinal hernia is detailed discussed in literature. Rates of incidence reach to 3,0% until 29,0%. (Ballantyne, 2001). Possible falsification refer to the relatively short space of observation just as well as the children who were operated on initial or contralateral out of the clinic, so they are out of focus. Emphatically spoken, there exist a connection between the age of the child during the primary operation and the increasing risk to develop a contralateral hernia. 72,7% of the patients with a hernia on the opposite side are younger than two months, 27,2% are between two months and two years old referring to the whole. Since indeed, there exist no reliable diagnostic method to verify the development of contralateral inguinal hernia and as the routine bilateral exploration at asymptomatic hernia is affected with insignificant low risk, the indication can be provided generously. The indication to the contralateral exploration is given because of the increasing occurrence of contralateral inguinal hernia in children who are younger than two months at the first operation. The routine exploration of boys of the opposite side in case of initial unilateral inguinal hernia can be recommended especially in the first two months of life conditioned by the accumulate occurrence to develop a contralateral hernia in these cases. Among the girls in case of presented inguinal hernia, the decision for bilateral exploration can be recommended until the end of the first two years of life. As children, who are older than two months at the time of primary care not develop significant frequently a hernia of the opposite side, the indication is first of all not given. Especially children with underlaying risk factors as prematurity in their previous history, very low birth weight and concomitant diseases which require a complicated anaesthesia represent possible contralateral exploration as an indication. The negligible low incidence of contralateral inguinal hernias in all other cases of patients, regardless of age or sex does not justify routine contralateral exploration in no way.","abstract_html":"Since the operative management of inguinal hernia in children has developed a routine procedure, the treatment of the contralateral side in infancy and childhood is still discussed controversial. In general, unilateral herniotomy is the most spreaded and most accepted method this time. There only exist agreement between pro-side and opposite side about contralateral exploration that several risk factors predispose the development of an inguinal hernia. Although, the basic question can not really answered with contentment finally: Which child does develop a contralateral inguinal hernia and which child does not? Aim of this report is to determine the factors which can affect the incidence of contralateral hernias in infants and children and which can lead to a hernia in progress. The result should simplify the treatment of high risk patients in view of a decision for or against a bilateral exploration. In the surgical department of the RWTH Aachen there were primary operated on an inguinal hernia between january 2000 and december 2003 368 children ( 278 boys and 90 girls) in the age of 0 until 16 years old. 22 of these children have to undergo a contralateral treatment at a later moment. The data are statistically analyzed with the programme SAS with the variable p&lt;0,05 as significant sign of the Wilcoxon-Test respectively the Kruskal-Wallis Test as well as the result of the Fisher-Test method. In 22 cases (6,0 %) of all 368 children the treatment of a contralateral hernia was necessary after first undergoing unilateral herniotomy. A significant tendency to develop a contralateral hernia in male and female patients can be found in relation to the age at the primary operation, the space of time between first and second operation, the choice of anaesthesia, the birth grown, the gestational age and the number of concomitant diseases. About 16 children (72,7%) develop an inguinal hernia on the opposite side during the first two months after initial treatment. There can now be established a significant effect between the space of time between primary and recurrent operative treatment and that especially during the two first postoperative months. The choice of anaesthesia is significant with p&lt; 0,0318. In 274 cases (74,5%) was utilized an endotracheal anaesthesia. Low birth weight infants develop more often a contralateral inguinal hernia compared with higher weight infants. Another risk factor is the gestational age, in the largest case 42 weeks of pregnancy and in the minimum 26 weeks of pregnancy. At last, there exist 8 children (36,4%) with a contralateral inguinal hernia with a relevant number of concomitant disease, significant statistically. Bilateral exploration of contralateral inguinal hernia is detailed discussed in literature. Rates of incidence reach to 3,0% until 29,0%. (Ballantyne, 2001). Possible falsification refer to the relatively short space of observation just as well as the children who were operated on initial or contralateral out of the clinic, so they are out of focus. Emphatically spoken, there exist a connection between the age of the child during the primary operation and the increasing risk to develop a contralateral hernia. 72,7% of the patients with a hernia on the opposite side are younger than two months, 27,2% are between two months and two years old referring to the whole. Since indeed, there exist no reliable diagnostic method to verify the development of contralateral inguinal hernia and as the routine bilateral exploration at asymptomatic hernia is affected with insignificant low risk, the indication can be provided generously. The indication to the contralateral exploration is given because of the increasing occurrence of contralateral inguinal hernia in children who are younger than two months at the first operation. The routine exploration of boys of the opposite side in case of initial unilateral inguinal hernia can be recommended especially in the first two months of life conditioned by the accumulate occurrence to develop a contralateral hernia in these cases. Among the girls in case of presented inguinal hernia, the decision for bilateral exploration can be recommended until the end of the first two years of life. As children, who are older than two months at the time of primary care not develop significant frequently a hernia of the opposite side, the indication is first of all not given. Especially children with underlaying risk factors as prematurity in their previous history, very low birth weight and concomitant diseases which require a complicated anaesthesia represent possible contralateral exploration as an indication. The negligible low incidence of contralateral inguinal hernias in all other cases of patients, regardless of age or sex does not justify routine contralateral exploration in no way.","abstract_has_math":false,"creators":["Vaaßen, Pia"],"institution":"Publikationsserver der RWTH Aachen University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Wenzl, Tobias Gregor"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2007,"date_issued":"2007","date_published":"2007","updated_at":"2026-07-30T19:43:28Z","subjects":["info:eu-repo/classification/ddc/610","Kontralaterale Leistenhernien","Medizin","contralateral inguinal hernia"],"languages":["ger"],"rights":["info:eu-repo/semantics/openAccess"],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-124011%22"],"render_values":[{"text":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-124011%22","href":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-124011%22","code":true}]}]},"links":{"outbound_url":"https://publications.rwth-aachen.de/record/62442","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Wenzl, Tobias Gregor"]},{"key":"dc:creator","label":"Author","values":["Vaaßen, Pia"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:coverage","label":"Dc Coverage","values":["DE"]},{"key":"dc:date","label":"Dc Date","values":["2007"]},{"key":"dc:publisher","label":"Institution","values":["Publikationsserver der RWTH Aachen University"]},{"key":"dc:relation","label":"Dc Relation","values":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-19681"]},{"key":"dc:type","label":"Dc Type","values":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["info:eu-repo/classification/ddc/610","Kontralaterale Leistenhernien","Medizin","contralateral inguinal hernia"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["ger"]},{"key":"dc:rights","label":"Dc Rights","values":["info:eu-repo/semantics/openAccess"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/record/62442","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-124011%22"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Since the operative management of inguinal hernia in children has developed a routine procedure, the treatment of the contralateral side in infancy and childhood is still discussed controversial. In general, unilateral herniotomy is the most spreaded and most accepted method this time. There only exist agreement between pro-side and opposite side about contralateral exploration that several risk factors predispose the development of an inguinal hernia. Although, the basic question can not really answered with contentment finally: Which child does develop a contralateral inguinal hernia and which child does not? Aim of this report is to determine the factors which can affect the incidence of contralateral hernias in infants and children and which can lead to a hernia in progress. The result should simplify the treatment of high risk patients in view of a decision for or against a bilateral exploration. In the surgical department of the RWTH Aachen there were primary operated on an inguinal hernia between january 2000 and december 2003 368 children ( 278 boys and 90 girls) in the age of 0 until 16 years old. 22 of these children have to undergo a contralateral treatment at a later moment. The data are statistically analyzed with the programme SAS with the variable p<0,05 as significant sign of the Wilcoxon-Test respectively the Kruskal-Wallis Test as well as the result of the Fisher-Test method. In 22 cases (6,0 %) of all 368 children the treatment of a contralateral hernia was necessary after first undergoing unilateral herniotomy. A significant tendency to develop a contralateral hernia in male and female patients can be found in relation to the age at the primary operation, the space of time between first and second operation, the choice of anaesthesia, the birth grown, the gestational age and the number of concomitant diseases. About 16 children (72,7%) develop an inguinal hernia on the opposite side during the first two months after initial treatment. There can now be established a significant effect between the space of time between primary and recurrent operative treatment and that especially during the two first postoperative months. The choice of anaesthesia is significant with p< 0,0318. In 274 cases (74,5%) was utilized an endotracheal anaesthesia. Low birth weight infants develop more often a contralateral inguinal hernia compared with higher weight infants. Another risk factor is the gestational age, in the largest case 42 weeks of pregnancy and in the minimum 26 weeks of pregnancy. At last, there exist 8 children (36,4%) with a contralateral inguinal hernia with a relevant number of concomitant disease, significant statistically. Bilateral exploration of contralateral inguinal hernia is detailed discussed in literature. Rates of incidence reach to 3,0% until 29,0%. (Ballantyne, 2001). Possible falsification refer to the relatively short space of observation just as well as the children who were operated on initial or contralateral out of the clinic, so they are out of focus. Emphatically spoken, there exist a connection between the age of the child during the primary operation and the increasing risk to develop a contralateral hernia. 72,7% of the patients with a hernia on the opposite side are younger than two months, 27,2% are between two months and two years old referring to the whole. Since indeed, there exist no reliable diagnostic method to verify the development of contralateral inguinal hernia and as the routine bilateral exploration at asymptomatic hernia is affected with insignificant low risk, the indication can be provided generously. The indication to the contralateral exploration is given because of the increasing occurrence of contralateral inguinal hernia in children who are younger than two months at the first operation. The routine exploration of boys of the opposite side in case of initial unilateral inguinal hernia can be recommended especially in the first two months of life conditioned by the accumulate occurrence to develop a contralateral hernia in these cases. Among the girls in case of presented inguinal hernia, the decision for bilateral exploration can be recommended until the end of the first two years of life. As children, who are older than two months at the time of primary care not develop significant frequently a hernia of the opposite side, the indication is first of all not given. Especially children with underlaying risk factors as prematurity in their previous history, very low birth weight and concomitant diseases which require a complicated anaesthesia represent possible contralateral exploration as an indication. The negligible low incidence of contralateral inguinal hernias in all other cases of patients, regardless of age or sex does not justify routine contralateral exploration in no way."]},{"key":"dc:source","label":"Dc Source","values":["Aachen : Publikationsserver der RWTH Aachen University VIII, 65 S. : Ill., graph. Darst. (2007). = Aachen, Techn. Hochsch., Diss., 2007"]},{"key":"dc:title","label":"Title","values":["Kontralaterale Leistenhernien im Kindes- und Jugendalter : gibt es Risikofaktoren für die Ausbildung einer kontralateralen Hernie? : Eine retrospektive Studie von 2000 bis 2002 und eine prospektive Auswertung aus dem Jahre 2003"]}]}],"canonical_facts":{"dc:contributor":["Wenzl, Tobias Gregor"],"dc:coverage":["DE"],"dc:creator":["Vaaßen, Pia"],"dc:date":["2007"],"dc:description":["Since the operative management of inguinal hernia in children has developed a routine procedure, the treatment of the contralateral side in infancy and childhood is still discussed controversial. In general, unilateral herniotomy is the most spreaded and most accepted method this time. There only exist agreement between pro-side and opposite side about contralateral exploration that several risk factors predispose the development of an inguinal hernia. Although, the basic question can not really answered with contentment finally: Which child does develop a contralateral inguinal hernia and which child does not? Aim of this report is to determine the factors which can affect the incidence of contralateral hernias in infants and children and which can lead to a hernia in progress. The result should simplify the treatment of high risk patients in view of a decision for or against a bilateral exploration. In the surgical department of the RWTH Aachen there were primary operated on an inguinal hernia between january 2000 and december 2003 368 children ( 278 boys and 90 girls) in the age of 0 until 16 years old. 22 of these children have to undergo a contralateral treatment at a later moment. The data are statistically analyzed with the programme SAS with the variable p<0,05 as significant sign of the Wilcoxon-Test respectively the Kruskal-Wallis Test as well as the result of the Fisher-Test method. In 22 cases (6,0 %) of all 368 children the treatment of a contralateral hernia was necessary after first undergoing unilateral herniotomy. A significant tendency to develop a contralateral hernia in male and female patients can be found in relation to the age at the primary operation, the space of time between first and second operation, the choice of anaesthesia, the birth grown, the gestational age and the number of concomitant diseases. About 16 children (72,7%) develop an inguinal hernia on the opposite side during the first two months after initial treatment. There can now be established a significant effect between the space of time between primary and recurrent operative treatment and that especially during the two first postoperative months. The choice of anaesthesia is significant with p< 0,0318. In 274 cases (74,5%) was utilized an endotracheal anaesthesia. Low birth weight infants develop more often a contralateral inguinal hernia compared with higher weight infants. Another risk factor is the gestational age, in the largest case 42 weeks of pregnancy and in the minimum 26 weeks of pregnancy. At last, there exist 8 children (36,4%) with a contralateral inguinal hernia with a relevant number of concomitant disease, significant statistically. Bilateral exploration of contralateral inguinal hernia is detailed discussed in literature. Rates of incidence reach to 3,0% until 29,0%. (Ballantyne, 2001). Possible falsification refer to the relatively short space of observation just as well as the children who were operated on initial or contralateral out of the clinic, so they are out of focus. Emphatically spoken, there exist a connection between the age of the child during the primary operation and the increasing risk to develop a contralateral hernia. 72,7% of the patients with a hernia on the opposite side are younger than two months, 27,2% are between two months and two years old referring to the whole. Since indeed, there exist no reliable diagnostic method to verify the development of contralateral inguinal hernia and as the routine bilateral exploration at asymptomatic hernia is affected with insignificant low risk, the indication can be provided generously. The indication to the contralateral exploration is given because of the increasing occurrence of contralateral inguinal hernia in children who are younger than two months at the first operation. The routine exploration of boys of the opposite side in case of initial unilateral inguinal hernia can be recommended especially in the first two months of life conditioned by the accumulate occurrence to develop a contralateral hernia in these cases. Among the girls in case of presented inguinal hernia, the decision for bilateral exploration can be recommended until the end of the first two years of life. As children, who are older than two months at the time of primary care not develop significant frequently a hernia of the opposite side, the indication is first of all not given. Especially children with underlaying risk factors as prematurity in their previous history, very low birth weight and concomitant diseases which require a complicated anaesthesia represent possible contralateral exploration as an indication. The negligible low incidence of contralateral inguinal hernias in all other cases of patients, regardless of age or sex does not justify routine contralateral exploration in no way."],"dc:identifier":["https://publications.rwth-aachen.de/record/62442","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-124011%22"],"dc:language":["ger"],"dc:publisher":["Publikationsserver der RWTH Aachen University"],"dc:relation":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-19681"],"dc:rights":["info:eu-repo/semantics/openAccess"],"dc:source":["Aachen : Publikationsserver der RWTH Aachen University VIII, 65 S. : Ill., graph. Darst. (2007). = Aachen, Techn. Hochsch., Diss., 2007"],"dc:subject":["info:eu-repo/classification/ddc/610","Kontralaterale Leistenhernien","Medizin","contralateral inguinal hernia"],"dc:title":["Kontralaterale Leistenhernien im Kindes- und Jugendalter : gibt es Risikofaktoren für die Ausbildung einer kontralateralen Hernie? : Eine retrospektive Studie von 2000 bis 2002 und eine prospektive Auswertung aus dem Jahre 2003"],"dc:type":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]},"updated_at":"2026-07-30T19:43:28Z"}