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Timing of inguinal hernia repair in children varies greatly among hernia surgeons
Christoffer Skov Olesen1, Kristoffer Andersen, Stina Öberg
1christofferskovolesen@gmail.com.
Insights
Danish surgeons show inconsistent timing for paediatric inguinal hernia repair, especially for reducible hernias. New guidelines and education are needed for optimal treatment of pediatric inguinal hernias.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Hernia Repair
Background:
- Disagreement exists regarding the optimal timing for surgical repair of inguinal hernias in children.
- Current practices among Danish surgeons for pediatric inguinal hernia repair timing were investigated.
Purpose of the Study:
- To explore how Danish surgeons approach the timing of inguinal hernia repair in pediatric patients based on age and hernia presentation.
- To identify variations in surgical planning for different types of inguinal hernias in children.
Main Methods:
- A validated questionnaire was distributed to all surgeons performing pediatric hernia repair in Denmark.
- Surgeons were surveyed on their planned repair timing for asymptomatic reducible, symptomatic reducible, incarcerated, and strangulated hernias across three age groups (<2, 2-12, 13-18 years).
Main Results:
- Responses were received from 48 surgeons (81% response rate).
- Significant variation in repair timing was observed for reducible and incarcerated hernias across all age groups.
- Broad consensus was found for the immediate repair of strangulated hernias.
Conclusions:
- The timing of pediatric inguinal hernia repair is inconsistent, particularly for reducible hernias.
- The findings highlight the need for updated clinical guidelines and educational initiatives on early versus delayed repair strategies.
Introduction:
Due to disagreement on optimal timing of inguinal hernia repair in children, we explored how Danish surgeons plan repair in children at different ages and with different symptoms.
Methods:
A validated questionnaire on timing of inguinal hernia repair in children was sent to all surgeons performing paediatric hernia repair in Denmark. The surgeons were asked how they plan repair of asymptomatic reducible, symptomatic reducible, incarcerated, and strangulated hernias in children aged less than 2, 2-12 and 13-18 years.
Results:
Forty-eight surgeons (81%) completed the questionnaire. Answers concerning the timing of repair of reducible and incarcerated hernias varied greatly for all age groups. For reducible hernias, the answers ranged from repairing within one week to considering watchful waiting. For incarcerated hernias, the answers ranged from repair within 12 hours to three months. There was broad agreement on the need for acute repair of strangulated hernias.
Conclusions:
Timing of paediatric inguinal hernia repair was inconsistent for children of all age groups and in particular for those with reducible hernias. The results call for a new guideline to ensure consistent and optimal treatment as well as an educational effort about the pros and cons of early and delayed repair.
Funding:
none.
Trial Registration:
not relevant.
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