Endosurgical treatment of premature infants with inguinal hernias

Abstract

Introduction. An inguinal hernia is a serious surgical issue in premature infants as this is one of the reasons leading to increased lethality and longer treatment duration. The purpose of the study was to estimate the possibility and effectiveness of endosurgical treatment of inguinal hernias in premature infants.Material and methods. 705 patients with inguinal hernias aged 0–3 months have been treated at the Center for Surgery of Newborns in Irkutsk during the last 15 years from January 2004 to December 2018. The gestational age of 51 infants was less than 37 weeks. All the patients underwent laparoscopic hernia repair with extracorporeal ligation. During the final stage of the study, demographic data, intra- and postoperative results were compared.Results. The experience of treating 51 premature infants with inguinal hernias was analyzed. The children were distributed into groups as follows: 1,500–2,500 g for 35 patients, 1,000–1,500 g for 14 patients, less than 1,000 g for 2 patients. The average weight and age was 1,870 g/36.9 days for children with low body weight, 1148.3 g/48.9 days for children with very low body weight and 810 g/69 days for children with extremely low body weight. The average surgery duration ranged from 28.8 min to 35 min. According to the results of the study, increased gestational age and body weight decreases the risk of postoperative apnea from 100% to 11.8%.Conclusion. It must be noted that minimally invasive surgeries are less traumatic and effective interventions when treating premature infants with inguinal hernias. In infants with premature hernias, a surgery is always associated with the risk of postoperative apnea and AVL dependent on the body weight and gestational age.

Video-assisted isolated percutaneous hernia sac suturing in children with inguinal hernia (VIPS)

“…Патология влагалищного отростка брюшины у детей, а именно в форме паховых грыж, встречается крайне часто, достигая показателей в 5-20 случаев на 1000 новорожденных, с явным превалированием мужского пола практически в 10 раз, а в детские хирургические отделения госпитализируют до 35 % детей именно с паховыми грыжами [1][2][3]. Отмечено, что данная патология значительно чаще, в 1,5-2 раза, встречается у недоношенных детей, что можно объяснить эмбриогенезом влагалищного отростка брюшины [4][5][6]. В детской когорте пациентов большую часть составляют косые паховые грыжи, а частота встречаемости прямых и бедренных грыж, включая их комбинации, не превышает 2 % [7,8].…”