Management of Inguinal Hernias in Premature Infants- Pre or Post Discharge- What Is Best?

Abstract

Incidence of inguinal hernias in premature infants is reported to be as high as 30%, making inguinal hernia repair one of the most common surgeries performed in children. Frequency of inguinal hernia is inversely related to birthweight with rates highest in the very low birth weight infants. Due to multiple comorbidities, most pediatric surgeon weight to operate on premature infants until they have reached 1800-2000g. The purpose of this retrospective study is to determine optimal time period for repair of inguinal hernias in premature infants and to establish the use of regional anesthesia as standard of care. In a retrospective chart review of premature infants undergoing inguinal hernia repair from 1997 to 2016, 134 cases were reviewed. Anesthesia complications were limited to 0.07% in the caudal group and none in the spinal anesthesia group. Hernia recurrence rate in this study was minimal at 0.01%. Inguinal hernias in premature infants should be repaired as early as they are healthy enough to be transferred out of the intensive care unit, taking adequate oral nutrition and do not have further supplemental oxygen requirements. Regional anesthesia should be anesthesia of choice in premature infants.