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Complications of inguinal herniotomy are comparable in term and premature infants

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Abstract

Purpose

Inguinal hernias are common, and prevalence is highest in premature males. Recognised complications include recurrence, iatrogenic cryptorchidism and testicular atrophy. We reviewed complication rates following inguinal herniotomy (IH), comparing premature (gestation <36 weeks) and term infants.

Methods

A retrospective case note review of infants aged 0–12 months undergoing IH between January 2006 and December 2010. Data collected included demographics, side of hernia, incarceration, complications, duration of follow-up and need for further surgery. Comparison was made using unpaired student t test and Fishers exact test.

Results

Four hundred and eight patients underwent IH (365 male, 42 female, 1 complete androgen insensitivity); 197 were premature (prem), mean weight 3.81 kg (1.02–9.4); 211 were term (gestation ≥36 weeks), mean weight 5.85 kg (2.4–11.7), p = 0.0001 versus prem. Total herniotomies performed = 472 (131 Left, 213 Right, 64 bilateral); 89 hernias were incarcerated at presentation (60 prem vs. 29 term, p = 0.0001). Bowel resection was required in six patients (5 prem vs. 1 term, p = 0.1109), and 14 had simultaneous orchidopexy (12 prem vs. 2 term, p = 0.0049). Early post-operative complication rate 2.8 % (8 prem vs. 5 term; p = 0.4037). Two hundred and forty patients attended follow-up; 58.8 % (125 prem, 115 term). This group accounted for 279 IH (264 male, 15 female). Mean follow-up = 5 months (0.5–36). Complication rates: recurrence 2.7 %, metachronous hernia 7.5 %, iatrogenic cryptorchidism 3.8 % and testicular atrophy 0.7 %.

Conclusion

No significant difference was found in complication rates between premature and term infants despite significantly more premature infants presenting with incarcerated hernias.

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References

  1. Lao BL, Fitzgibbons RJ, Cusick RA (2012) Pediatric inguinal hernias, hydroceles, and undescended testicles. Surg Clin N Am 92:487–504

    Article  PubMed  Google Scholar 

  2. Lau ST, Lee Y, Caty MG (2007) Current management of hernias and hydroceles. Semin Pediatr Surg 16:50–57

    Article  PubMed  Google Scholar 

  3. Monoharna S, Samarakkody U, Kulkarni M et al (2005) Evidence-based change of practice in the management of unilateral inguinal hernia. J Pediatr Surg 40:1163–1166

    Article  Google Scholar 

  4. Meier AH, Ricketts RR (2003) Surgical complications of inguinal and abdominal wall hernias. Semin Pediatr Surg 12(2):83–88

    Article  PubMed  Google Scholar 

  5. Rosenberg J (2008) Pediatric inguinal hernia repair-a critical appraisal. Hernia 12:113–115

    Article  CAS  PubMed  Google Scholar 

  6. Nagraj S, Sinha S, Grant H et al (2006) The incidence of complications following primary inguinal herniotomy in babies weighing 5 kg or less. Pediatr Surg Int 20:500–502

    Article  Google Scholar 

  7. Vogel HDE, Bruijnen CJP, Beasley SW (2009) Predictors of recurrence after inguinal herniotomy in boys. Pediatr Surg Int 25:235–238

    Article  Google Scholar 

  8. Turnock RR, Jones MO, Lloyd DA (1994) Preperitoneal approach to irreducible inguinal hernia in infants. BJS 81(2):251

    Article  CAS  Google Scholar 

  9. Baird R, Gholoum S, Leberge JM et al (2011) Prematurity, not age at operation or incarceration, impacts complication rates of inguinal hernia repair. J Pediatr Surg 46:908–911

    Article  PubMed  Google Scholar 

  10. Brooker RW, Keenan WJ (2006) Inguinal hernia: relationship to respiratory disease in prematurity. J Pediatr Surg 41:1818–1821

    Article  PubMed  Google Scholar 

  11. Phelps S, Agrawal M (1997) Morbidity after neonatal inguinal herniotomy. J Pediatr Surg 32(3):445–447

    Article  CAS  PubMed  Google Scholar 

  12. Ein SH, Njere I, Ein A (2006) Six thousand three hundred sixty-one pediatric inguinal hernias: a 35 year review. J Pediatr Surg 41:980–986

    Article  PubMed  Google Scholar 

  13. Miltenburg DM, Nuchtern JG, Jaksic T et al (1998) Laparoscopic evaluation of the pediatric inguinal hernia-a meta-analysis. J Pediatr Surg 3(6):874–879

    Article  Google Scholar 

  14. Birk D, Formentini A, Poch B et al (1999) “No-puncture-laparoscopy” in hernia management in childhood—reliable complement to established therapy concepts. Chirug 70(3):290–293

    Article  CAS  Google Scholar 

  15. Steven M, Grenee O, Nelson A (2010) Contralateral inguinal exploration in premature neonates: is it necessary? Pediatr Surg Int 26:703–706

    Article  PubMed  Google Scholar 

  16. Puri P, Guiney EJ, O’Donnell B (1984) Inguinal hernia in infants: the fate of the testis following incarceration. J Pediatr Surg 19:44–46

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Paediatric Surgery, Alder Hey Children’s Hospital NHS Foundation Trust, Liverpool, L12 2AP, UK

    K. Hughes, J. F. Horwood, C. Clements, D. Leyland & H. J. Corbett

Authors
  1. K. Hughes
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  2. J. F. Horwood
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  3. C. Clements
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  4. D. Leyland
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  5. H. J. Corbett
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Corresponding author

Correspondence to H. J. Corbett.

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Conflicts of interest

K.H, F.H, C.C, D.L and H.C declares no conflict of interest.

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Hughes, K., Horwood, J.F., Clements, C. et al. Complications of inguinal herniotomy are comparable in term and premature infants. Hernia 20, 565–569 (2016). https://doi.org/10.1007/s10029-015-1454-6

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  • DOI: https://doi.org/10.1007/s10029-015-1454-6

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