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Early versus late inguinal hernia repair in extremely low-birthweight infants
Rajesh Pandey1,2, Joleen Dako1, Sarah Venus3
1a Department of Pediatrics , Division of Neonatology, Case Western Reserve University School of Medicine, MetroHealth Medical Center , Cleveland , OH , USA.
Insights
Early versus late inguinal hernia repair in extremely low-birthweight infants showed similar outcomes. This study found no significant differences in complications between early and late surgical repair for inguinal hernias in ELBW infants.
Area of Science:
- Neonatal Surgery
- Pediatric Surgery
- Critical Care Medicine
Background:
- Extremely low-birthweight (ELBW) infants are at increased risk for inguinal hernias (IH).
- The optimal timing for IH repair in ELBW infants remains a subject of clinical debate.
- Early repair is often performed before hospital discharge, while late repair occurs after discharge.
Purpose of the Study:
- To compare the clinical outcomes of extremely low-birthweight infants undergoing early (before discharge) versus late (after discharge) inguinal hernia repair.
- To identify any significant differences in complications and recovery between the two repair timing groups.
Main Methods:
- Retrospective study analyzing data from ELBW infants diagnosed with inguinal hernias.
- Data abstraction included clinical characteristics, timing of IH repair (early vs. late), and associated outcomes.
- Statistical analysis compared patient demographics, IH-related complications, and postoperative events between early and late repair groups.
Main Results:
- Of 252 ELBW infants, 39 (15.4%) developed IH. Early repair (59%) and late repair (41%) groups were comparable in birth weight and gestational age.
- The early repair group experienced prolonged respiratory support (60.6 days vs. 39 days, p=0.032) but had earlier corrected gestation at repair (41.6 weeks vs. 45.4 weeks, p<0.01).
- Rates of incarceration, postoperative apnea, infections, recurrence, and testicular atrophy were not significantly different between the early and late repair groups.
Conclusions:
- No significant differences in overall outcomes were observed between early and late inguinal hernia repair in extremely low-birthweight infants.
- The findings suggest that timing of repair may not critically impact major IH-related complications in this vulnerable population.
- Further research may be warranted to explore specific subgroups or refine management strategies.
Objective:
Compare outcomes of extremely low-birthweight (ELBW) infants following early (before discharge) versus late (after discharge) inguinal hernia (IH) repair.
Study Design:
In a retrospective study of ELBW infants with IH, data were abstracted for clinical characteristics, IH and related outcomes.
Result:
Of the 39/252 (15.4%) ELBW infants who developed IH, those with early (59%) versus late (41%) repair were comparable in birth weight (753 ± 158 versus 744 ± 131 g, p = 0.84), gestation age (26 ± 2 versus 26.2 ± 2 weeks, p = 0.92), with comparable rate of broncopulmonary dysplasia (87% versus 75%, p = 0.41), but early repair group had prolonged respiratory support (60.6 ± 28.6 versus 39 ± 30 days, p = 0.032). Both groups had comparable diagnosis to repair interval (51.2 ± 29.2 versus 60.5 ± 30.6 days, p = 0.38) and early repair group has earlier corrected gestation (41.6 ± 3.9 versus 45.4 ± 4.6 weeks, p < 0.01) at time of repair. Post-IH repair complications (incarceration, postoperative apnea, infections, recurrence and testicular atrophy) were not different.
Conclusions:
We did not find significant differences in outcomes of IH in early and late repair groups of ELBW infants.
