Ann Surg Treat Res.  2023 May;104(5):296-301. 10.4174/astr.2023.104.5.296.

Optimal timing for inguinal hernia repair in premature infants: surgical issues for inguinal hernia in premature infants

• Cho YJ
• Kwon H
• Ha S
• Kim SC
• Kim DY
• Namgoong JM
• Nam SH
• Lee JY
• Jung E
• Cho MJ

• KMID: 2542237
• DOI: http://doi.org/10.4174/astr.2023.104.5.296

Abstract

Purpose
We analyzed the timing of inguinal hernia repair in premature infants in the neonatal intensive care unit (NICU) considering recurrence, incarceration, and other complications.
Methods
In this multicenter retrospective review, premature infants (<37 weeks) in the NICU diagnosed with inguinal hernia between 2017 and 2021 were segregated into 2 groups based on the timing of inguinal hernia repair.
Results
Of 149 patients, 109 (73.2%) underwent inguinal hernia repair in the NICU and 40 (26.8%) after discharge. Preoperative incarceration did not differ, but complications with recurrence and postoperative respiratory insufficiency were higher in the NICU group (11.0% vs. 0%, P = 0.029; 22.0% vs. 5.0%, P = 0.01). Multivariate analysis showed that the significant factors affecting recurrence were preoperative ventilator dependence and body weight of <3,000 g at the time of surgery (odds ratio [OR], 16.89; 95% confidence interval [CI], 3.45–82.69; P < 0.01 and OR, 9.97; 95% CI, 1.03–95.92; P = 0.04).
Conclusion
Our results suggest that when premature infants are diagnosed with inguinal hernia in the NICU, inguinal hernia repair after discharge may decrease the odds of recurrence and postoperative respiratory insufficiency. In patients who have difficulty delaying surgery, it is thought that surgery should be performed carefully in a ventilator preoperatively or weighed <3,000 g at the time of surgery.

Keyword

Inguinal hernia; Herniorrhaphy; Premature infant; Respiratory insufficiency

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