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Complications of inguinal herniotomy are comparable in term and premature infants
K Hughes1, J F Horwood1, C Clements1
1Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, L12 2AP, UK.
Insights
Inguinal hernias are common in premature infants. This study found no significant difference in complication rates after inguinal herniotomy (IH) between premature and term infants, despite higher incarceration rates in premature cases.
Area of Science:
- Pediatric Surgery
- Neonatal Medicine
- Surgical Outcomes
Background:
- Inguinal hernias are prevalent, particularly in premature male infants.
- Recognized complications include recurrence, iatrogenic cryptorchidism, and testicular atrophy.
Purpose of the Study:
- To review complication rates following inguinal herniotomy (IH).
- To compare complication rates between premature (gestation <36 weeks) and term infants.
Main Methods:
- Retrospective case note review of infants aged 0-12 months undergoing IH (January 2006 - December 2010).
- Data collected: demographics, hernia side, incarceration, complications, follow-up duration, need for further surgery.
- Statistical comparison using unpaired student t-test and Fisher's exact test.
Main Results:
- 408 patients underwent IH; 197 premature and 211 term infants.
- Premature infants had significantly higher rates of incarcerated hernias at presentation (p=0.0001).
- Overall complication rates (recurrence, metachronous hernia, iatrogenic cryptorchidism, testicular atrophy) showed no significant difference between premature and term infants.
Conclusions:
- Despite higher rates of incarcerated hernias in premature infants, complication rates following inguinal herniotomy are similar between premature and term infants.
- This suggests that timely surgical intervention for inguinal hernias in premature infants is safe and effective.
Purpose:
Inguinal hernias are common, and prevalence is highest in premature males. Recognised complications include recurrence, iatrogenic cryptorchidism and testicular atrophy. We reviewed complication rates following inguinal herniotomy (IH), comparing premature (gestation <36 weeks) and term infants.
Methods:
A retrospective case note review of infants aged 0-12 months undergoing IH between January 2006 and December 2010. Data collected included demographics, side of hernia, incarceration, complications, duration of follow-up and need for further surgery. Comparison was made using unpaired student t test and Fishers exact test.
Results:
Four hundred and eight patients underwent IH (365 male, 42 female, 1 complete androgen insensitivity); 197 were premature (prem), mean weight 3.81 kg (1.02-9.4); 211 were term (gestation ≥36 weeks), mean weight 5.85 kg (2.4-11.7), p = 0.0001 versus prem. Total herniotomies performed = 472 (131 Left, 213 Right, 64 bilateral); 89 hernias were incarcerated at presentation (60 prem vs. 29 term, p = 0.0001). Bowel resection was required in six patients (5 prem vs. 1 term, p = 0.1109), and 14 had simultaneous orchidopexy (12 prem vs. 2 term, p = 0.0049). Early post-operative complication rate 2.8 % (8 prem vs. 5 term; p = 0.4037). Two hundred and forty patients attended follow-up; 58.8 % (125 prem, 115 term). This group accounted for 279 IH (264 male, 15 female). Mean follow-up = 5 months (0.5-36). Complication rates: recurrence 2.7 %, metachronous hernia 7.5 %, iatrogenic cryptorchidism 3.8 % and testicular atrophy 0.7 %.
Conclusion:
No significant difference was found in complication rates between premature and term infants despite significantly more premature infants presenting with incarcerated hernias.
