Effect of Early vs Late Inguinal Hernia Repair on Serious Adverse Event Rates in Preterm Infants

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  • HIHIP Trial Investigators
    HIP Trial Investigators
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Abstract
Inguinal hernia is one of the most common congenital abnormalities requiring surgery in preterm infants. The incidence of inguinal hernia increases as gestational age decreases, reaching 40% in males born at 24 weeks’ gestation.1 Treatment is operative repair to prevent inguinal hernia incarceration (rate range, 5%-28%),2,3 but the safest timing for repair remains controversial.4,5 Preterm infants with inguinal hernia usually also have serious comorbidities (eg, acute respiratory distress syndrome, bronchopulmonary dysplasia, retinopathy of prematurity, and intraventricular hemorrhage),6 and undergoing the repair before discharge from the neonatal intensive care unit has raised concerns for surgical and anesthetic complications, possible prolonged mechanical ventilation, fragility of the tissues involved with the repair, and possible delayed discharge.4 Delaying the operation until after discharge from the neonatal intensive care unit possibly lowers those risks, but may increase hernia-related complications. The literature regarding optimal timing consists of retrospective analyses,7-11 but no practice guideline recommendations.

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