Early repair of inguinal hernia in premature babies

Abstract

Inguinal hernia (IH) is relatively common in premature newborn infants, and the timing of surgical correction is controversial. We studied 40 premature infants who developed an IH and who were initially treated in a neonatal intensive care unit. Birth weight (BW) ranged from 492 to 2,401 g; 21 infants had a BW less than 1,000 g. The weight of the infants at operation ranged from 1,000 to 4,400 g. Twenty-one patients underwent herniotomy within 2 weeks after the diagnosis (short waiting group), in which 1 case of incarceration occurred; 19 waited longer than 2 weeks between diagnosis and surgery (long waiting group). Two cases of strangulation occurred in this latter group, and in 1 of those testicular necrosis occurred. Operation time was analysed in boys with bilateral herniotomy (n = 25): the short waiting group (n = 12) showed a significantly reduced operation time compared to the long waiting group (n = 13). Patients weighing less than 1,000 g at birth (n = 21) had a longer average waiting period for surgery. In the group of male patients with bilateral herniotomy, average operation time was longer in the group weighing less than 1,000 g at birth (n = 13) than in the group over 1,000 g (n = 12). Body weight at surgery did not affect operation time. It is concluded that early hernia repair should be considered in premature infants to avoid operative difficulties and gonadal ischaemia caused by incarceration.

Assessment and Management of Inguinal Hernia in Infants

“…26 Uemura et al reported comparable inguinal hernia incarceration rates in 19 preterm infants (birth weight range 492-2401 g) who underwent repair at more than 2 weeks after diagnosis, compared with 21 preterm infants who underwent more urgent repair. 27 Although these studies suggest that inguinal hernia repair can be delayed, the data are not as compelling as those suggesting repair on a more urgent basis.…”

Inguinal hernia in neonates and ex-preterm: complications, timing and need for routine contralateral exploration

“…Vaos in 2010 [4] and Uemura in 1999 [28] demonstrated that the sooner the patients are operated on upon diagnosis, the lower is the risk of complications. Conversely, Lautz and colleagues [3] recently stated that delaying surgery of newborns and ex-preterms after discharge from the hospital does not increase the risk of complications.…”

“…Thirteen were ELWB, 25 were VLBW and 49 were LBW babies. The remaining 67 patients had a birth weight higher than 2,500 g. Median PCA at birth was 36 weeks (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41).…”

Peritonea-vaginal canal pathologies at Regional Hospital Center of Lomé-Commune (Togo): Epidemiological, anatomoclinical and therapeutic aspects

“…[3,14] Thus, Uemura et al as well as Galinier et al recommended that any inguinal hernia diagnosed in an infant should be operated earlier in order to avoid strangulation. [15,16] We have not had cases of strangulated hernia in children. This is due to the fact that children admitted for emergency surgical conditions are often referred to Teaching hospitals because of anesthetic safety.…”