Contralateral inguinal exploration in premature neonates: is it necessary?

Pediatr Surg Int. 2010 Jul;26(7):703-6. doi: 10.1007/s00383-010-2614-5. Epub 2010 May 8.

Abstract

Purpose: The purpose of this study was to review our management of neonatal inguinal hernias in premature infants over a 5-year period to ascertain any change in practice.

Methods: Premature infants who underwent inguinal herniotomy between 2002 and 2006 were identified. Case notes were analyzed recording patient demographics, primary side, complications, recurrence and how many re-presented with a metachronous hernia.

Results: 172 preterm infants were identified: 162 males (94.2%) and 10 females (5.8%). Median gestation was 31 weeks (25-36.7). Eighteen (10.4%) were incarcerated. Median age at surgery was 66.5 days (0-284). Thirty-two (18.6%) had bilateral hernias. Of the 63 who underwent unilateral herniotomy, 9 (14.3%) re-presented with a metachronous hernia. Median time to returning was 24 days. The number of contralateral explorations decreased over the study period. The complication rate was 6.4%. Median follow-up was 2.83 years (0.33-5.4).

Conclusions: This is one of the largest series showing the current practice in managing preterm infants with inguinal hernia. There are limitations to this study and the follow-up period is short. The value of contralateral groin exploration in premature neonates remains doubtful and we have shown that the overall practice has changed.

MeSH terms

  • Female
  • Follow-Up Studies
  • Hernia, Inguinal / pathology
  • Hernia, Inguinal / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / pathology
  • Infant, Premature, Diseases / surgery*
  • Male
  • Postoperative Complications
  • Recurrence
  • Retrospective Studies
  • Unnecessary Procedures* / trends