title: Management of inguinal hernia in premature infants: 10-year experience.
abstract: OBJECTIVE
  Debatable issues in the management of inguinal hernia in premature infants remain unresolved. This study reviews our experience in the management of inguinal hernia in premature infants.
  
  
  METHODS
  Retrospective chart review of premature infants with inguinal hernia from 1999 to 2009. Infants were grouped into 2: Group 1 had repair (HR) just before discharge from the neonatal intensive care unit (NICU) and Group 2 after discharge.
  
  
  RESULTS
  Eighty four premature infants were identified. None of 23 infants in Group 1 developed incarcerated hernia while waiting for repair. Of the 61 infants in Group 2, 47 (77%) underwent day surgery repair and 14 were admitted for repair. At repair mean postconceptional age (PCA) in Group1 was 39.5 ± 3.05 weeks. Mean PCA in Group 2 was 66.5 ± 42.73 weeks for day surgery infants and 47.03 ± 8.87 weeks for admitted infants. None of the 84 infants had an episode of postoperative apnea. Five (5.9%) infants presented subsequently with metachronous contralateral hernia and the same number of infants had hernia recurrence.
  
  
  CONCLUSIONS
  Delaying HR in premature infants until ready for discharge from the NICU allows for repair closer to term without increasing the risk of incarceration. Because of low occurrence of metachronous hernia contralateral inguinal exploration is not justified. Day surgery HR can be performed in former premature infant if PCA is >47 weeks without increasing postoperative complications.
authors.affiliation: Department of Surgery, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
authors.forename: Stanley John
authors.initials: SJ
authors.lastname: Crankson
authors.affiliation: Department of Pediatrics, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
authors.forename: Khalil
authors.initials: K
authors.lastname: Al Tawil
authors.affiliation: Department of Surgery, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Al Namshan
authors.affiliation: Department of Surgery, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
authors.forename: Saud
authors.initials: S
authors.lastname: Al Jadaan
authors.affiliation: Department of Pediatrics, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
authors.forename: Beverly Jane
authors.initials: BJ
authors.lastname: Baylon
authors.affiliation: Department of Surgery, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
authors.forename: Mutaz
authors.initials: M
authors.lastname: Gieballa
authors.affiliation: Department of Pediatrics, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
authors.forename: Ibrahim Hakim
authors.initials: IH
authors.lastname: Ahmed
keywords: Complications; inguinal hernia; premature infant; timing of repair