Results of treatment of inguinal hernias in premature infants

BACKGROUND: The conditions of premature infants are increasingly part of the daily routine of pediatric surgeons. Inguinal hernia is one of the typical conditions in this group of patients. However, no unified and secure patient data curation algorithm has been developed in Russia or worldwide.
AIM: The aim of the study was to evaluate the outcomes of early versus delayed surgical strategies for planned hernia repair in premature infants.
MATERIALS AND METHODS: A retrospective study conducted between 2012 and 2021 included 82 premature infants divided into two groups, with surgery performed in early lactation in 58 (70.7%) patients and at 50 postconceptional weeks in 24 (29.3%) patients.
RESULTS: In group 1, weight and postconceptional age of the children were significantly lower, 941.6 ± 463.5 g and 38.6 ± 3.1 weeks vs. 1458.8 ± 798.6 g and 54.9 ± 10.8 weeks (significance level p = 0.0004 and p = 0.0001, respectively). Faster surgery was reported for delayed herniorrhaphy. The duration of surgery was 59.2 ± 23.7 min in group 1 and 32.1 ± 18.1 min in group 2 (p = 0.0001). There were no differences in intraoperative complications between two groups. Oxygen dependence in the postoperative period was observed in 5 children (8.6%) in the early surgery group and in one child (4.2%) in the second group (p = 0.6656). The total time spent in the hospital after surgery in group 2 was significantly less than in group 1. The mean number of bed days after surgery was 29.7 ± 31.2 in group 1 and 1.6 ± 2.1 in group 2 (p = 0.0023).
CONCLUSIONS: Therefore, surgical treatment of inguinal hernia in premature infants after 50 weeks of postconceptional age is technically easier than surgery in the early stage of breastfeeding. It may reduce the risk of intraoperative complications, the potential for postoperative respiratory distress, the risk of postoperative complications, the duration of surgery, and the total length of hospital stay of an infant after herniorrhaphy