Complications while awaiting elective inguinal hernia repair in infants: Not as common as you thought.

Autor: Ferrantella A; DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, FL. Electronic address: https://twitter.com/JESola1., Sola JE; DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, FL. Electronic address: https://twitter.com/DrChadTHOR., Parreco J; DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, FL., Quiroz HJ; DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, FL. Electronic address: https://twitter.com/halliequirozmd., Willobee BA; DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, FL., Reyes C; Department of Pediatric Hospital Medicine, Nicklaus Children's Hospital, Miami, FL., Thorson CM; DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, FL. Electronic address: https://twitter.com/TonyFerrantella., Perez EA; DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, FL. Electronic address: EPerez3@med.miami.edu.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2021 Jun; Vol. 169 (6), pp. 1480-1485. Date of Electronic Publication: 2021 Jan 23.
DOI: 10.1016/j.surg.2020.12.016
Abstrakt: Background: The dogma of early inguinal hernia repair in infants, especially those born prematurely, has dominated clinical practice owing to reports of a high frequency of incarceration and significant complications associated with untreated inguinal hernias. We aim to evaluate the frequency of complications after discharge with delayed surgery for inguinal hernia repair.
Methods: The Nationwide Readmissions Database (2010-2014) was queried to identify infants diagnosed with inguinal hernia. We compared the frequency and characteristics of inguinal hernia repair performed during the index admission, discharge from the index admission without hernia repair, and unplanned readmissions.
Results: We identified 33,530 infants (16,624 preterm and 16,906 full-term) diagnosed with an inguinal hernia during an index admission. For those infants diagnosed with an inguinal hernia at birth, inguinal hernia repair was performed during the birth admission for only a minority of both preterm (35%) and full-term infants (18%; P < .001). Of the infants discharged without hernia repair, 15% required nonelective readmission up to 1 year later, but only 2% of preterm and 1% of full-term infants actually underwent inguinal hernia repair during these unplanned readmissions. None of the readmitted infants underwent additional procedures suggestive of a strangulated hernia.
Conclusion: Complications among infants awaiting inguinal hernia repair may be substantially less common than previously reported, and the occurrence of significant associated morbidity is quite rare.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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