Investigation of Validity of Early Inguinal Hernia Repair in Premature Infants

Abstract

Purpose: Early inguinal hernia repair for preterm infants can prevent complications related to incarceration, but may increase technical and respiratory complications. Thus, the optimal timing for repair in preterm infants remains debatable. We aimed to clarify the safety and validity of repair before discharge from the neonatal intensive care unit (NICU).

Methods: From 2009 to 2022, 21 preterm patients whose inguinal hernia was repaired before discharge were studied as the NICU group, and 32 outpatients whose inguinal was diagnosed early but repaired at two months of age were studied as the control group. We collected both clinical data and compared outcomes statistically.

Results: In the NICU group, 15 (71%) of the 21 patients were male, and 10 had bilateral repair, a mean birth weight of 1,330 g, and a mean weight at surgery of 2,860 g. None of the mean unilateral, bilateral, and total operating times had significant differences between both groups (unilateral, 18.0 vs 17.7 min, p = 0.750; bilateral, 38.8 vs 35.4 min, p = 0.432; total, 27.9 vs 21.6 min, p = 0.051). In the NICU group, there was only one postoperative complication, namely, transient desaturation, and no recurrence during the median follow-up period of 42 months. The metachronous contralateral inguinal hernia was found in one patient in the NICU group and four patients in the control group.

Conclusions: Early repair in preterm infants before discharge from NICU is appropriate. To reduce postoperative complications, surgeons and pediatricians should adequately assess the patients’ clinical states.