title: Fifty-three-year experience with pediatric umbilical hernia repairs.
abstract: OBJECTIVE
  The aim of this study was to evaluate the long-term surgical and patient-reported outcomes of pediatric umbilical hernia (UH) repairs.
  
  
  METHODS
  A retrospective review of all children (<18 years old) who underwent UH repair at Mayo Clinic-Rochester in the last half century was done. Follow-up was obtained by mailed survey.
  
  
  RESULTS
  From 1956 to 2009, 489 children (boys, 251; girls, 238) underwent a primary UH repair. The mean age was 3.9 years (range, 0.01-17.8 years). Complicated UHs that required emergent repair (n = 34, or 7%) included recurrent incarceration (22), enteric fistula (7), strangulation (4), and evisceration (1). Mean UH size was 1.3 cm (range, 0.2-7.0 cm), varying by operative indication (1.0 cm emergent vs 1.5 cm elective repairs, P = .008) and decade of repair (2.2 cm, 1950s-60s vs 1.3 cm, 1990s-2000s; P = .001). Postoperative morbidity (2%) consisted of superficial wound infection (7), hematoma (3), and seroma (1). With a 66% survey response rate and mean follow-up of 13.0 years (range, 0-53.8 years), 8 (2%) patients experienced a recurrence. Most patients reported satisfaction (90%) with the cosmetic appearance of their umbilicus and are pain free (96%).
  
  
  CONCLUSIONS
  Pediatric UH repairs have low morbidity and recurrence rates. Most patients are satisfied and pain free. Importantly, complicated UHs were more likely to be associated with smaller defects; therefore, parental counseling for signs of incarceration is recommended even in small defects.
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Zendejas
authors.forename: Admire
authors.initials: A
authors.lastname: Kuchena
authors.forename: Edwin O
authors.initials: EO
authors.lastname: Onkendi
authors.forename: Christine M
authors.initials: CM
authors.lastname: Lohse
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Moir
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ishitani
authors.forename: D Dean
authors.initials: DD
authors.lastname: Potter
authors.forename: David R
authors.initials: DR
authors.lastname: Farley
authors.forename: Abdalla E
authors.initials: AE
authors.lastname: Zarroug
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004630:Emergencies; D004954:Esthetics; D005260:Female; D006554:Hernia, Umbilical / Q000453:epidemiology / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome