Study of clinical outcomes in neonates with inguinal hernia - A prospective study

Abstract

IntroductionInguinal hernia is one of the commonest surgical problem in neonates. There is controversy regarding timing of neonatal inguinal hernia repair and incidence of complications with respect to early or delayed repair. ObjectiveThe aim of this study was to determine the occurrence of complications in neonates diagnosed with inguinal hernia and undergoing inguinal herniotomy. MethodologyProspective observational study was conducted at a tertiary-care teaching hospital, between February 2015 and December 2017. A total of 141 neonates (term newborn up to 4 weeks of age and preterm newborns up to 40 + 4 weeks of post-conceptional age) diagnosed with inguinal hernia were enrolled. They were followed through the entire course from diagnosis to surgery and six months post-operatively. Complications like preoperative incarceration, postoperative apnea, wound infection and hernia recurrence were recorded. ResultsIn this study, 121 (85.8%) babies were born pre-term, mean birth weight was 1900 ± 784 g and mean post-conceptional age at diagnosis was 35.8 ± 4.8 weeks. Majority (98.5%) were operated electively with mean observation time of 87.7 ± 43.1 days. Mean weight at time of surgery was 3801 ± 956 g. Two babies presented with irreducible hernia. Post-operative apnea was seen in 9/141 (6.4%), minor wound infection in 3 (2.1%), hydrocele in 4 (2.8%) and recurrence of hernia in 7 (4.9%). ConclusionThe risk of incarceration is low in neonates discharged with known diagnosis of inguinal hernia. Postoperative apnea and recurrence of hernia is higher in pre-term neonates undergoing surgery before 48 weeks post-conceptional age.