title: Incisional hernia in pediatric surgery - experience at a single UK tertiary centre.
abstract: OBJECTIVE
  Incisional hernia (IH) is a recognized complication of open and laparoscopic visceral surgery, with reported rates of 10-50% in adult surgical literature. There is a paucity of data relating to incisional hernias in children. The aim of our study was to analyze the incidence and treatment of IH in children.
  
  
  METHODS
  Retrospective review of all patients admitted for incisional hernia repair at a tertiary pediatric surgical centre in the UK more than a 7-year period was performed. Data collected included age at initial surgery, time to IH repair, and type of IH repair and postoperative complications.
  
  
  RESULTS
  Twenty one patients (14 male) underwent IH repair during the study period. The incidence of IH among children who had primary abdominal surgery in our institution less than the age of 6months was 2.3%. Median age at repair was 7.9months (range: 18days-5years). Median time from primary surgery to diagnosis of IH was 2months (range 0day-3years), with 81% (17/21) diagnosed within 1year of the preceding abdominal procedure. The most common pathology necessitating the primary operative procedure was necrotising enterocolitis (n=9) in babies of gestational age less than 30weeks. The highest rates of IH were noted in infants following closure of stoma (7.5%) and pyloromyotomy (2.52%). Primary closure was undertaken in all cases. Two children had recurrence of IH, one of which underwent surgical repair.
  
  
  CONCLUSIONS
  Incidence of IH in children is low but significant. IH was most commonly diagnosed following closure of stoma for NEC in this study.
authors.affiliation: Department of Paediatric Surgery, Addenbrooke's Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom. Electronic address: drdhanyauk@yahoo.co.uk.
authors.forename: Dhanya
authors.initials: D
authors.lastname: Mullassery
authors.affiliation: Department of Paediatric Surgery, Addenbrooke's Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom.
authors.forename: Ami
authors.initials: A
authors.lastname: Pedersen
authors.affiliation: Department of Paediatric Surgery, Addenbrooke's Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Robb
authors.affiliation: Department of Paediatric Surgery, Addenbrooke's Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom.
authors.forename: Nicola
authors.initials: N
authors.lastname: Smith
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D059685:Herniorrhaphy / Q000379:methods; D006801:Humans; D015994:Incidence; D000069290:Incisional Hernia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Abdominal surgery; Incisional hernia; Pediatric surgery