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Inguinal hernia repair in early infancy.

R L Moss¹, E I Hatch

¹Virginia Mason Medical Center, Seattle, Washington.

American Journal of Surgery

|May 1, 1991

Summary

Prompt surgical repair of inguinal hernias in infants under two months is safe and effective. This approach minimizes complications and yields outcomes similar to those in older children.

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Area of Science:

Pediatric Surgery
Neonatal Care
Surgical Management

Background:

Management of inguinal hernias in young infants is controversial.
The study addresses optimal timing and techniques for infant inguinal hernia repair.

Purpose of the Study:

To evaluate the safety and efficacy of immediate surgical repair for inguinal hernias in infants under two months.
To assess incarceration rates, management strategies, and outcomes compared to older children.

Main Methods:

Retrospective review of 384 infants (<2 months) undergoing inguinal herniorrhaphy (1985-1990).
Analysis of incarceration, preoperative reduction success, repair timing, contralateral exploration, recurrence, and complication rates.
Evaluation of anesthesia's impact, specifically spinal anesthesia.

Main Results:

24% of infants presented with incarcerated hernias; 96% had successful preoperative reduction.
Immediate repair (within 48 hours) was performed; no bowel resections were needed.
Contralateral groin exploration was positive in 85% of cases.
Recurrence rate was 1.0%, and complications occurred in 2.3% of patients.
Spinal anesthesia in 63 patients showed no postoperative apnea.

Conclusions:

An aggressive approach with prompt repair of inguinal hernias in young infants is safe and effective.
Repair in the first two months yields low recurrence and complication rates, comparable to older children.
Spinal anesthesia may reduce postoperative apnea in infants.

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