Impact of obesity on contralateral patent processus vaginalis and perioperative factors in pediatric patients with inguinal hernia

Purpose: The prevalence of childhood overweight and obesity (OB-OV) has increased worldwide, but its influence on contralateral patent processus vaginalis (CPPV) and perioperative outcomes in unilateral inguinal hernia is unclear. This study evaluated the association of OB-OV with CPPV, and with anesthesia induction time and surgical site infection (SSI) incidence. Methods: This retrospective study included 178 pediatric patients who underwent laparoscopic surgery for unilateral inguinal hernia between April 2013 and March 2022 at our institution; 27 had OB-OV and 151 served as controls. Presence of CPPV, hernia side (right vs left), demographic variables (age, sex), and perioperative variables—including anesthesia induction time, operative time, and postoperative complications—were compared between groups using the chi-square test and Mann–Whitney U test. Multivariable logistic regression analysis was performed to evaluate the association between OB-OV and CPPV after adjustment for age and sex. Results: OB-OV was associated with a higher CPPV detection rate (p = 0.01), longer anesthesia induction times (p < 0.01), and a higher incidence of SSI (p = 0.04). In multivariable analysis, OB-OV was independently associated with CPPV (odds ratio 3.23; 95% CI 1.38–8.00; p < 0.01). Conclusion: In pediatric patients undergoing laparoscopic repair of unilateral inguinal hernia, OB-OV was associated with higher rates of CPPV, longer anesthesia induction time, and higher rates of SSI. Recognizing this risk may inform perioperative decision-making and preoperative counseling.