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KMID : 0371420231040050296
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Annals of Surgical Treatment and Research
2023 Volume.104 No. 5 p.296 ~ p.301
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Optimal timing for inguinal hernia repair in premature infants: surgical issues for inguinal hernia in premature infants
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Cho Yu-Jeong
Kwon Hyun-Hee
Ha Su-Hyeon
Kim Bo-Ah
Kim Dae-Yeon
Namgoong Jung-Man
Nam So-Hyun
Lee Ju-Yeon
Jung Eun-Young
Cho Min-Jeng
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Abstract
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Purpose : We analyzed the timing of inguinal hernia repair in premature infants in the neonatal intensive care unit (NICU) considering recurrence, incarceration, and other complications.
Methods : In this multicenter retrospective review, premature infants (<37 weeks) in the NICU diagnosed with inguinal hernia between 2017 and 2021 were segregated into 2 groups based on the timing of inguinal hernia repair.
Results : Of 149 patients, 109 (73.2%) underwent inguinal hernia repair in the NICU and 40 (26.8%) after discharge. Preoperative incarceration did not differ, but complications with recurrence and postoperative respiratory insufficiency were higher in the NICU group (11.0% vs. 0%, P = 0.029; 22.0% vs. 5.0%, P = 0.01). Multivariate analysis showed that the significant factors affecting recurrence were preoperative ventilator dependence and body weight of <3,000 g at the time of surgery (odds ratio [OR], 16.89; 95% confidence interval [CI], 3.45?82.69; P < 0.01 and OR, 9.97; 95% CI, 1.03?95.92; P = 0.04).
Conclusion : Our results suggest that when premature infants are diagnosed with inguinal hernia in the NICU, inguinal hernia repair after discharge may decrease the odds of recurrence and postoperative respiratory insufficiency. In patients who have difficulty delaying surgery, it is thought that surgery should be performed carefully in a ventilator preoperatively or weighed <3,000 g at the time of surgery.
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KEYWORD
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Inguinal hernia, Herniorrhaphy, Premature infant, Respiratory insufficiency
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