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

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A Letter to the Editor to this article was published on 13 June 2019

Abstract

Background/purpose

Aim of this study was to present a series of neonates and ex-preterm babies who underwent inguinal hernia repair focusing on complications and possible indication to perform routine contralateral groin exploration.

Methods

This is a retrospective study of a series of consecutive patients weighing less than 5 kg who underwent inguinal hernia repair between January 2007 and December 2012. Only the affected side was treated. Patients have been routinely followed up postoperatively. We resorted to available outpatients’ charts and admission notes to record demographic data, surgical details, complications and the occurrence of metachronous hernias. A questionnaire was administered to all patients’ relatives to confirm the long-term outcome.

Results

One hundred fifty-four patients were operated for a total of 184 herniotomies (88 right sided, 36 left sided and 30 bilateral). Median length of follow-up was 42 months (range 6 months–7.5 years). Thirteen patients (13/124 = 10.5 %) developed metachronous hernia that proved to be significantly more frequent in patients weighing less than 1,500 g at birth (p < 0.05). We observed 10 % of complications, including 2.7 % testicular atrophy and 4.5 % recurrence. Atrophy proved to occur more frequently in patients who experienced preoperative incarceration (p < 0.05). No other risk factors were identified.

Conclusions

The results of our series demonstrated that, though technically demanding, herniotomy in the neonate and ex-preterm is associated with a relatively low incidence of complications. Based on our results and in accordance with literature data, we do not advocate routine contralateral exploration in case of unilateral hernia but surgery to be performed only on the symptomatic side, as soon as possible after initial diagnosis. Very low birth weight patients should be followed with care in the early postoperative period due to the higher likelihood of developing a metachronous hernia.

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Authors and Affiliations

  1. Paediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy

    A. Pini Prato, V. Rossi, M. Mosconi, A. Michelazzi, F. Faranda, S. Avanzini, P. Buffa & G. Mattioli

  2. University of Genoa, DINOGMI, Genoa, Italy

    N. Disma, L. Mameli & G. Montobbio

  3. Anaesthesiology Unit, Istituto Giannina Gaslini, Genoa, Italy

    P. Tuo & G. Mattioli

  4. Neonatology Unit, Istituto Giannina Gaslini, Genoa, Italy

    L. Ramenghi

Authors
  1. A. Pini Prato
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  2. V. Rossi
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  3. M. Mosconi
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  4. N. Disma
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  7. A. Michelazzi
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  12. P. Tuo
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  13. G. Mattioli
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Correspondence to A. Pini Prato.

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Pini Prato, A., Rossi, V., Mosconi, M. et al. Inguinal hernia in neonates and ex-preterm: complications, timing and need for routine contralateral exploration. Pediatr Surg Int 31, 131–136 (2015). https://doi.org/10.1007/s00383-014-3638-z

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  • DOI: https://doi.org/10.1007/s00383-014-3638-z

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