Early repair of inguinal hernia in premature babies

Inguinal hernia (IH) is relatively common in premature newborn infants, and the timing of surgical correction is controversial. We studied 40 prematur e infants who developed an IH and who were initially treated in a neonatal intensive care unit. Birth weight (BW) ranged from 492 to 2,401 g; 21 infan ts had a BW less than 1,000 g. The weight of the infants at operation range d from 1,000 to 4,400 g. Twenty-one patients underwent herniotomy within 2 weeks after the diagnosis (short waiting group), in which 1 case of incarce ration occurred: 19 waited longer than 2 weeks between diagnosis and surger y (long waiting group). Two cases of strangulation occurred in this latter group, and in 1 of those testicular necrosis occurred. Operation time was a nalysed in boys with bilateral herniotomy (n = 25). the short waiting group (n = 12) showed a significantly reduced operation time compared to the lon g waiting group (n = 13). Patients weighing less than 1,000 g at birth (n = 21) had a longer average waiting period for surgery. In the group of male patients with bilateral herniotomy. average operation time was longer in th e group weighing less than 1,000 g at birth (n = 13) than in the group over 1,000 g (n = 12). Body weight at surgery did not affect operation time. It is concluded that early hernia repair should be considered in premature in fants to avoid operative difficulties and gonadal ischaemia caused by incar ceration.