Management of inguinal hernia in premature infants: 10-year experience

Aim: Debatable issues in the management of inguinal hernia in premature infants remain unresolved. This study reviews our experience in the management of inguinal hernia in premature infants. Materials and Methods: Retrospective chart review of premature infants with inguinal hernia from 1999 to 200...

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Bibliographic Details
Published in:Journal of Indian Association of Pediatric Surgeons 2015-01, Vol.20 (1), p.21-24
Main Authors: Crankson, Stanley, Al Tawil, Khalil, Al Namshan, Mohammad, Al Jadaan, Saud, Baylon, Beverly, Gieballa, Mutaz, Ahmed, Ibrahim
Format: Article
Language:English
Subjects:
Age
Babies
Complications
Females
Hernias
Imprisonment
Infants (Premature)
Inguinal hernia
Laparoscopy
Original
Pediatrics
Premature birth
premature infant
Studies
Surgery
Surgical outcomes
timing of repair
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Summary:Aim: Debatable issues in the management of inguinal hernia in premature infants remain unresolved. This study reviews our experience in the management of inguinal hernia in premature infants. Materials and Methods: Retrospective chart review of premature infants with inguinal hernia from 1999 to 2009. Infants were grouped into 2: Group 1 had repair (HR) just before discharge from the neonatal intensive care unit (NICU) and Group 2 after discharge. Results: Eighty four premature infants were identified. None of 23 infants in Group 1 developed incarcerated hernia while waiting for repair. Of the 61 infants in Group 2, 47 (77%) underwent day surgery repair and 14 were admitted for repair. At repair mean postconceptional age (PCA) in Group1 was 39.5 ± 3.05 weeks. Mean PCA in Group 2 was 66.5 ± 42.73 weeks for day surgery infants and 47.03 ± 8.87 weeks for admitted infants. None of the 84 infants had an episode of postoperative apnea. Five (5.9%) infants presented subsequently with metachronous contralateral hernia and the same number of infants had hernia recurrence. Conclusions: Delaying HR in premature infants until ready for discharge from the NICU allows for repair closer to term without increasing the risk of incarceration. Because of low occurrence of metachronous hernia contralateral inguinal exploration is not justified. Day surgery HR can be performed in former premature infant if PCA is >47 weeks without increasing postoperative complications.
ISSN:0971-9261
1998-3891
DOI:10.4103/0971-9261.145440