Is the Laparoscopic Approach Safe for Inguinal Hernia Repair in Preterms?

Abstract

Introduction: Although laparoscopic inguinal hernia repair in children has gained popularity in the last decades, this approach remains uncommon in preterm infants. The aim of this study was to compare the characteristics and the outcomes of indirect inguinal hernias in term and preterm infants. Material and Methods: From January 2002 to November 2015, all charts of the pediatric patients who underwent laparoscopic indirect inguinal hernia repair in one single institution within the first 6 months of life were revised. The data of 156 patients were analyzed retrospectively. Patients were divided in two groups: group I, including the preterm patients, and group II, including the term patients. Results: A total of 90 preterm infants and 66 term infants were included. In the group I, preoperative diagnosis was right-sided inguinal hernia in 20% of patients, left sided in 22.2%, and bilateral in 57.5%; while in the group II, preoperative diagnosis was right-sided inguinal hernia in 42.4% of infants, left sided in 15.2%, and bilateral in 42.4% (P = .01). In group I intraoperative diagnosis was right-sided inguinal hernia in 10% of patients, left sided in 16.7%, and bilateral in 73.3%; while in the group II, intraoperative diagnosis was right-sided inguinal hernia in 25.8% of infants, left sided in 12.1%, bilateral in 60.6%, and there was no hernia in one patient (P = .02). However, there was no statistically significant difference in the correct intraoperative diagnosis between both groups (P = .59). No statistical significance was observed between the two groups regarding postoperative complications. Conclusions: Bilateral inguinal hernia is more frequent in preterm infants compared to term infants, whereas the incidence of right-sided inguinal hernia is higher in term patients. Laparoscopic inguinal hernia repair in preterm infants seems to be safe and effective.