A critical review of premature infants with inguinal hernias: optimal timing of repair, incarceration risk, and postoperative apnea.
OBJECTIVE
This study evaluated the optimal timing for repair, incarceration risk, and postoperative apnea rate in premature infants with inguinal hernias.


METHODS
This was a retrospective review of premature infants undergoing inguinal hernia repairs from 2006 to 2008.


RESULTS
One hundred seventy-two patients were identified. Mean gestational age was 30.7 weeks, and mean birth weight was 1428 g. At repair, mean postconceptional age was 46.6 weeks with mean weight of 3688 g. Elective repairs were performed on 127 patients. Thirty-five patients were discharged with a known hernia, and none developed incarceration. No postoperative apnea episodes occurred in any of these 127 patients. Forty-five patients had herniorrhaphy before discharge from the neonatal intensive care unit (NICU) with a median postoperative hospitalization of 8 days (2-51 days). Thirteen percent required prolonged (>48 hours) intubation after repair. Of 172 patients, 8 (4.6%) developed incarcerated hernia. Five incarcerations occurred in the NICU before discharge, and 3 patients had incarceration as their initial presentation.


CONCLUSIONS
There is minimal risk of postoperative apnea for premature infants undergoing elective inguinal hernia repair. The risk of incarceration in premature infants discharged from the NICU with a known hernia is low. Herniorrhaphy before discharge from the NICU was associated with a prolonged hospital stay.
Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA 90509, USA. slleemd@yahoo.com
Steven L
SL
Lee
Joseph M
JM
Gleason
Roman M
RM
Sydorak
D001049:Apnea / Q000453:epidemiology*; D001724:Birth Weight; D015897:Comorbidity; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D013502:General Surgery / Q000379:methods; D005865:Gestational Age; D006552:Hernia, Inguinal / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D010372:Pediatrics / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome