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Analysis of 3,776 pediatric inguinal hernia and hydrocele cases in a tertiary center
Derya Erdoğan1, Ibrahim Karaman, Mustafa Kemal Aslan
1Dr Sami Ulus Maternity and Children's Research and Training Hospital - Pediatric Surgery Department, Ankara, Turkey. deryaerdo@yahoo.com
Insights
Pediatric inguinal hernia and hydrocele surgeries were analyzed in 3776 patients. Outcomes show low complication rates, with higher risks in newborns and incarcerated hernias, and no need for routine contralateral exploration.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Pediatric Urology
Background:
- Tertiary care training hospitals manage a significant volume of pediatric inguinal hernia and hydrocele cases.
- Understanding surgical outcomes is crucial for optimizing patient care and training.
Purpose of the Study:
- To describe the experience and outcomes of pediatric inguinal hernia and hydrocele surgeries at a tertiary care training hospital.
- To analyze patient demographics, hernia characteristics, and postoperative complications.
Main Methods:
- Retrospective review of 3776 patients operated for inguinal hernia, cord hydrocele, or hydrocele between January 2005 and June 2009.
- Data collected included patient demographics, hernia laterality, age at presentation, and postoperative outcomes including complications and reoperations.
- Surgical procedures and patient follow-up were conducted by pediatric surgery specialists and residents.
Main Results:
- The study included 3776 patients (78.4% male, 21.6% female) aged 6 days to 17 years.
- Inguinal hernias were most common on the right (61.1%), followed by the left (29.4%) and bilateral (9.5%).
- Overall postoperative complications occurred in 1.2% of patients, with reoperations for wound infection (0.6%) and recurrence (0.4%) being most frequent. Higher complication rates were observed in newborns and incarcerated hernias.
Conclusions:
- Younger age at first hernia symptoms was noted in males and premature infants.
- The recurrent hernia rate was higher in infants, and complication rates increased in the newborn period and with incarcerated hernias.
- Routine contralateral exploration was not indicated, suggesting a tailored approach based on clinical presentation.
Background/Purpose:
This study describes the pediatric inguinal hernia and hydrocele experience of a tertiary care training hospital.
Methods:
A total of 3776 patients who had been operated between January 2005 and June 2009 for inguinal hernia, cord hydrocele, and hydrocele were included. The surgeries and patient follow-up were performed by 6 pediatric surgery specialists and 8 pediatric surgery residents.
Results:
The patient age varied from 6 days to 17 years. There were 2959 (78.4%) males and 817 (21.6%) females (ratio: 3.6:1). The hernia was on the right in 2306 (61.1%) patients, on the left in 1111 (29.4%) patients, and bilateral in 359 (9.5%) patients. Age at presentation was younger in males (p<.001). Contralateral hernia repair was required later on during follow-up in 2% of the patients. Postoperative complications developed in 1.2% of the patients. Reoperation was needed because of wound infection in 0.6%, recurrence in 0.4%, hematoma in 0.1%, testicular atrophy in 1 patient, and acquired undescended testis in 1 patient.
Conclusions:
The age of first hernia symptoms was younger in males compared to females and in premature babies compared to term babies (p<.05). The recurrent hernia rate was higher in infancy. The complication rate was higher in hernia surgery in the newborn period and in cases of incarcerated hernia compared to the overall rate (p<.05). There was no indication for contralateral routine exploration.
