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Inguinal hernias in premature neonates: exploring optimal timing for repair

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Abstract

Purpose

Inguinal hernias have been reported in as many as 10–30% premature neonates, making inguinal herniorrhaphy (IHR) one of the most commonly performed surgical procedures. The timing of surgery remains controversial. The purpose of this report is to compare outcomes of IHR while in the NICU (inpatient) versus repair following discharge (outpatient) to determine optimal timing.

Methods

Premature neonates having undergone IHR over a 5-year period were identified and a retrospective case cohort analysis was performed.

Results

263 patients underwent IHR during the 5-year study period with 115 (43.7%) having surgical repair inpatient (IP; prior to discharge) and 148 having outpatient herniorrhaphy (OP). Patients with IHR performed IP had significantly lower birth weight (p < 0.001), gestational age (p < 0.001), longer duration of surgery (p = 0.01) and were more likely to have post-operative ventilator dependence following repair; however, there were no differences in the rate of recurrence (p = 0.44) and incarceration (p = 0.45).

Conclusion

Our study demonstrated no significant differences in the rates of incarceration or recurrence, following in- or out-patient IHR. These findings suggest that IHR can potentially be offered as an outpatient procedure following hospital discharge in appropriate patients. The optimal timing of IHR in premature infants remains elusive and will likely require additional multicenter investigation.

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Funding

No external source of funding was utilized for this study.

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Authors and Affiliations

  1. Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Rd., P.O. Box 10019, Gainesville, FL, USA

    Faraz A. Khan, Nadine Zeidan, Shawn D. Larson, Janice A. Taylor & Saleem Islam

Authors
  1. Faraz A. Khan
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  2. Nadine Zeidan
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  3. Shawn D. Larson
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  4. Janice A. Taylor
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  5. Saleem Islam
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Corresponding author

Correspondence to Saleem Islam.

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Conflict of interest

Authors have no relevant financial disclosures or conflicts of interest.

Ethical approval

This article is a retrospective chart review performed on deidentified patient data. Approval by the institutional IRB was obtained.

Informed consent

Informed consent was not applicable as this study is a retrospective chart review performed on deidentified patient data.

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Khan, F.A., Zeidan, N., Larson, S.D. et al. Inguinal hernias in premature neonates: exploring optimal timing for repair. Pediatr Surg Int 34, 1157–1161 (2018). https://doi.org/10.1007/s00383-018-4356-8

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  • DOI: https://doi.org/10.1007/s00383-018-4356-8

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