Related Experiment Video
Updated: Aug 26, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Low prevalence of complications of delayed herniotomy in the extremely premature infant
M González Santacruz1, J Mira Navarro, A Encinas Goenechea
1Neonatal Unit, Department of Paediatrics, Hospital General Universitario de Alicante, Alicante, Spain. mgonzalezsantacruz@yahoo.es
Insights
Delaying herniotomy in extremely premature infants until hospital discharge does not increase risks of incarceration or testicular atrophy. This study compared premature infants with full-term infants undergoing inguinal hernia repair.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Surgical Outcomes
Background:
- Inguinal hernia is common in premature infants.
- Delayed surgical repair in neonates may increase complication risks.
Purpose of the Study:
- To investigate the relationship between delayed herniotomy and complication rates in extremely premature infants compared to full-term infants.
Main Methods:
- A follow-up study compared three groups: short-wait premature (SWG), long-wait premature (LWG), and full-term (FTG) infants.
- Variables analyzed included gestational age, weight, hernia side, timing, surgery details, hospitalization, and complications like apnea, incarceration, and testicular atrophy.
Main Results:
- Timing of surgery was significantly different between the long-wait premature group and the other two groups.
- Preoperative incarceration occurred in one SWG, two LWG, and four FTG infants (p=0.138).
- Testicular atrophy was found in one FTG and one SWG infant (p=0.221).
Conclusions:
- Deferring herniotomy in extremely premature infants until they are ready for discharge does not appear to elevate the risk of incarceration or testicular atrophy.
- Current practices of delaying surgery in this population seem safe regarding these specific complications.
Aim:
To study the relationship between the delay of herniotomy in the extremely premature infant and the rate of complications in comparison with full-term children.
Methods:
A follow-up study of three groups of neonates operated on for inguinal hernia was performed. The groups were defined as: a) the short-waiting group (SWG): prematures (mean gestational age: 32.56 +/- 0.62; n = 9) operated on within 2 wk of diagnosis (median: 5 d); b) the long-waiting group (LWG): prematures (mean gestational age: 28.38 +/- 1; n = 21) operated on after more than 2 wk (median: 39 d); and c) control group of full-term children (FTG); (mean gestational age: 38.18 +/- 0.29; median of timing: 3 d; n = 11). Several variables (gestational age, weight at birth and at surgery, side of the inguinal herrnia, timing, duration of surgery, type of anaesthesia, length of hospitalization), as well as the occurrence of apnoea, incarceration and testicular atrophy were compared between groups.
Results:
Timing was the only variable that was different between the LWG and the other two groups (p < 0.001, ANOVA). Seven preoperative episodes of incarceration occurred: one in the SWG, two in the LWG and four in the FTG (p = 0.138, chi2). In the follow-up study two testicular atrophies, related to previous episodes of incarceration, were found: one in the FTG and the other in the SWG (p = 0.221, chi2).
Conclusion:
The deferral of herniotomy in the extremely premature infant, until the child is ready to be discharged from the neonatal unit, does not seem to increase the risk of incarceration episodes or testicular atrophy.
