Optimal timing for repair of an inguinal hernia in premature infants.
OBJECTIVE
The aim of this study was to determine the optimal timing for inguinal herniotomy in premature infants treated in the neonatal intensive care unit.


METHODS
A two-institutional-center retrospective study was performed including 41 prematures at gestational age 28-35 weeks who underwent herniotomy within 1 week of diagnosis [short-waiting group (SWG), median 5 days, n = 25] or more than 1 week after diagnosis [long-waiting group (LWG), median 30.55 days, n = 16]. Gestational age, birthweight, post-conceptional age at diagnosis, age at diagnosis, post-conceptional age at surgery, age at surgery, weight at surgery, timing of surgery, operative time, and occurrence of incarceration, postoperative apnea, hernia recurrence, testicular atrophy, and hospital stay were compared between the two groups. Statistical analysis was performed using one-way ANOVA.


RESULTS
Twelve preoperative episodes of incarceration occurred: three in the SWG and nine in the LWG (P < 0.05). Six infants had apnea postoperatively: four in the SWG and two in the LWG (P > 0.05). Follow-up revealed five hernia recurrences, one in the SWG and four in the LWG (P < 0.05); four testicular atrophies were found, one in the SWG and three in the LWG (P > 0.05).


CONCLUSIONS
Early elective herniotomy should be considered in prematures in order to avoid perioperative morbidity and to reduce the risk of incarceration and subsequent testicular ischemia, and hernia recurrence.
Vaos
George
G
Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, 68100, Alexandroupolis, Greece. gvaos@med.duth.gr
Gardikis
Stefanos
S
Kambouri
Katerina
K
Sigalas
Ioannis
I
Kourakis
George
G
Petoussis
George
G
D000704:Analysis of Variance; D001284:Atrophy / Q000150:complications; D017558:Elective Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D013737:Testis / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome