RECURRENT INGUINAL-HERNIAS IN INFANTS AND CHILDREN

The objective of this study was to analyze the etiologic factors possi bly associated with the development of recurrent groin hernias in infa nts and children. For this purpose we analyzed the records of 2754 ped iatric patients operated on for primary hernias between 1966 and 1990 at our department who have not had recurrences. They were compared wit h 28 boys and 4 girls we treated for recurrent hernias during the same period. We found an indirect hernia in 29 cases, a direct hernia in 4 patients, and a femoral hernia in 1 child at the time of reoperation. A significantly high recurrence rate was found to be associated with incarceration (21.9% versus 7.6%), postoperative complications (9.4% v ersus 1.8%), concomitant diseases (31.2% versus 5.7%), and premature b irth. Day case treatment was closely related to concomitant diseases. No impact on the development of recurrences was seen for the surgeons' educational level and the time of day the surgery was performed. Know ledge of the factors contributing to hernia recurrence and perfect sur gical technique with reduction of incarcerated hernias and early elect ive operation may result in fewer recurrences in infants and children.