Management of inguinal hernia in children can be enhanced by closer follow-up by consultant pediatric surgeons.
OBJECTIVE
To determine if follow-up by consultant pediatric surgeons (CPS) affects morbidity due to incarceration (INC) in children with indirect inguinal hernia (IH).


METHODS
We educate parents so they can identify possible INC and advise them to attend our emergency department anytime for immediate review by on-call CPS.


RESULTS
We reviewed 3,493 cases of IH by grouping them according to age at diagnosis: neonatal (G1; n = 96), 2-3 months (G2; n = 331), 4-6 months (G3; n = 118), 7-12 months (G4; n = 193), and over 12 months (G5; n = 2,755). Data per group were: mean gestational age (weeks): 32.1, 38.0, 36.4, 37.4, 38.7; mean birth weight (g): 1,645, 2,736, 2,471, 2,769, 2,930; mean age at elective hernia repair (HR) (months): 11.3, 4.9, 10.1, 12.9, 56.5; mean weight at elective HR (kg): 6.8, 6.4, 7.3, 9.1, 17.4; mean duration from diagnosis to elective HR (months): 10.9, 3.1, 6.3, 3.6, 3.0; mean follow-up: 6.7 years. Overall, INC occurred in 203/3,493 during follow-up. Incidence per group was: G1: 4/96, G2: 62/331, G3: 6/118, G4: 47/193, G5: 84/2,755. All INC were reduced manually without complications. HR complications occurred in 7/3,493 (0.2%).


CONCLUSIONS
With CPS follow-up, INC can be managed without morbidity, allowing elective HR to be performed later with fewer complications.
Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Shogo
S
Seo
Tsubasa
T
Takahashi
Takashi
T
Marusasa
Junichi
J
Kusafuka
Hiroyuki
H
Koga
Abudebieke
A
Halibieke
Geoffrey J
GJ
Lane
Tadaharu
T
Okazaki
Atsuyuki
A
Yamataka
D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D012017:Referral and Consultation; D012189:Retrospective Studies; D013043:Specialties, Surgical; D013997:Time Factors