Early repair of inguinal hernia in preterm infants with oxygen-dependent bronchopulmonary dysplasia.

Despite inguinal hernia being both common and problematic in a significant proportion of preterm infants with bronchopulmonary dysplasia (BPD), there has been a reluctance to intervene surgically for fear of exacerbating the underlying lung disease. We report our experience of early operation in 12 consecutive infants with varying degrees of oxygen-dependent BPD and investigate the effect of general anaesthesia and herniotomy on pulmonary function by measuring oxygen requirements prior to and following operation. Two infants who required oxygen in a concentration in excess of 95% failed to improve and died from the pulmonary disease 6 and 8 weeks following their operation. The remaining infants all showed a reduction in mean oxygen requirements in the weeks following operation. We conclude that, in the short term, hernia repair performed under general anaesthesia in infants with BPD of varying severity had no adverse effects on respiratory function, as determined by oxygen requirements. We suggest that in certain infants early repair may have been beneficial--potential mechanisms are explored.