Correlation between ventriculoperitoneal shunts and inguinal hernias in children: an 8-year follow-up.

Abstract

The goal of this study was to investigate the correlation between ventriculoperitoneal shunts (VPSs) and inguinal hernias (IHs) in children. Study subjects were identified from a nationwide cohort of 1 537 843 children aged 0 to 5 years from 1996 to 2000. They were assigned to the VPS group (n=675), who received VPS, or a control group (n=6704) of age- and gender-matched children. Both groups (N=7379) were followed up for 8 years for IH. Kaplan-Meier and Cox regression analyses were performed. After the 8-year follow-up, 353 of the 7379 study subjects (78 from the VPS group and 275 from the control group) underwent IH surgery. The 8-year cumulative incidence rate of IH-repair surgery was 13.3% in the VPS group, significantly higher than that in the control group (4.1%; P<.001). Children in the VPS group were more likely to develop IH than the control group (hazard ratio: 3.62; P<.001), even after adjusting for age, gender, and comorbidities (adjusted hazard ratio: 6.63; P<.001). The average time interval between VPS and IH surgery was 1.73 years earlier in the VPS group than those in the control group (1.29 vs 3.02 years; P<.001). Children who received a VPS when younger than 5 years were more likely to have IH; the highest risk was during the first 2 years after VPS surgery. A high index of suspicion for inguinal manifestations is recommended during their follow-up.