Management of Inguinal Hernia in Pediatric Age Group

Abstract

Introduction: Incidence of indirect inguinal hernias in premature infants is reported to be as high as 30% with male predominance. Typically, inguinal hernia repairs are done under general anesthesia which has a high risk of post-operative complications, especially in the premature infant. The purpose of this study was to compare outcomes between early (neonatal) and delayed (older) inguinal hernia repair. Method: This is a prospective study in the department of pediatric surgery in alkhansaa Teaching Hospital Mosul / Iraq during a period from Jul 2018 to Dec 2019. All children with inguinal hernia were selected for the study and divided in two groups, those below one month and those above. Surgery is performed under general anesthesia with extracanalicular approach. Post-operative complications were observed and finally decided to discharge once patient is fit for discharge on the same day. Results: During the 18 months' period, we underwent 93 inguinal hernia repair those babies were divided into two groups, neonatal group (23 neonates) and older group (70 babies). The gender distribution ratio is 7.8 male :1 female. The side distribution among those babies in the neonatal group were 14,6 and 3 as right, left and bilateral respectively. In the neonatal group there were 9 babies presented with incarceration two (8.6%) of them shows testicular infarction and necrosis which necessitate excision at exploration while the other one atrophied in the period of follow up. We do not record any anesthetic complications or mortality in neonatal group in our period of study. Conclusion: Extracanalicular approach under general anesthesia is easy, safe, can be used for pediatric patients in neonatal age group with indirect inguinal hernia; with minimal complications, low recurrence rate.