Trend (in 2005) of Repair of Inguinal Hernia in Children in Korea : A National Survey by the Korean Association of Pediatric Surgeons in 2005

Kim, Seong Min; Kim, Dae Yeon; Kim, Sang Yoon; Kim, Seong Chul; Kim, Woo Ki; Kim, Jae Eok; Kim, Jae Chun; Park, Kwi Won; Seo, Jeong Meen; Song, Young Tack; Oh, Jung Tak; Lee, Nam Hyuk; Lee, Doo Sun; Chun, Yong Soon; Chung, Sang Young; Chung, Eul Sam; Choi, Kum Ja; Choi, Soon Ok; Han, Seok Joo; Huh, Young Soo; Hong, Jeong; Choi, Seung Hoon

Abstract

Inguinal hernia is the most common disease treated by the pediatric surgeon. There are several controversial aspects of management 1)the optimal timing of surgical repair, especially for preterm babies, 2)contralateral groin exploration during repair of a clinically unilateral hernia, 3)use of laparoscope in contralateral groin exploration, 4)timing of surgical repair of cord hydrocele, 5)perioperative pain control, 6)perioperative management of anemia. In this survey, we attempted to determine the approach of members of KAPS to these aspects of hernia treatment. A questionnaire by e-mail or FAX was sent to all members. The content of the questionnaire were adapted from the "American Academy of Pediatrics (AAP) Section on Surgery hernia survey revisited (J Pediatr Surg 40, 1009-1014, 2005)". For full-term male baby, most surgeons (85.7 %) perform an elective operation as soon as diagnosis was made. For reducible hernia found in ex-preterm infants already discharged from the neonatal intensive care unit (NICU), 76.2 % of surgeons performed an elective repair under general anesthesia (85.8 %). 42.9 % of the surgeons performed the repair just before discharge. For same-day surgery for the ex-premature baby, the opinion was evenly divided. For an inguinal hernia with a contralateral undescended testis in a preterm baby, 61.9 % of surgeons choose to 'wait and see' until 12 month of age. The most important consideration in deciding the timing of surgery of inguinal hernia in preterm baby was the existence of bronchopulmonary dysplasia (82.4 %), episode of apnea/bradycardia on home monitoring (70.6 %). Most surgeons do not explore the contralateral groin during unilateral hernia repair. Laparoscope has not been tried. Most surgeons do not give perioperative analgesics or blood transfusion.