K Hughes1, J F Horwood1, C Clements1, D Leyland1, H J Corbett2. 1. Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, L12 2AP, UK. 2. Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, L12 2AP, UK. Harriet.Corbett@alderhey.nhs.uk.
Abstract
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.
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.
Authors: Kristin A Sonderman; Lindsey L Wolf; Lindsey B Armstrong; Kathryn Taylor; Wei Jiang; Brent R Weil; Tracey P Koehlmoos; Robert L Ricca; Christopher B Weldon; Adil H Haider; Samuel E Rice-Townsend Journal: Pediatr Surg Int Date: 2018-03-28 Impact factor: 1.827