EC Paediatrics

Inguinal hernia is a frequent condition in preterm infants, and deciding when to repair it is one of the most crucial aspects of management. Timing of repair involves balancing the risk of hernia-related complications, such as incarceration, with the risks associated with anesthesia in a population prone to respiratory and neurological complications. This updated review will focus extensively on the timing of repair, integrating the latest evidence, while also covering surgical approaches and anesthesia considerations [1,2].

1. Fu YW., et al. “A nationwide survey of incidence rates and risk factors of inguinal hernia in preterm children”. Pediatric Surgery International 1 (2018): 91-95.
2. Patoulias I., et al. “Inguinal hernia management in preterm infants: addressing current issues of interest”. Folia Medica Cracoviensia 4 (2020): 41-52.
3. Pogorelić Z., et al. “Comparison of recurrence and complication rates following laparoscopic inguinal hernia repair among preterm versus full-term newborns: a systematic review and meta-analysis”. Children (Basel)10 (2021): 853.
4. Lesher AP and Chess PR. “Regional anesthesia may improve cardiorespiratory complications in preterm inguinal hernia surgery”. Journal of Perinatology 3 (2021): 370-371.
5. Dohms K., et al. “Inguinal hernia repair in preterm neonates: is there evidence that spinal or general anaesthesia is the better option regarding intraoperative and postoperative complications? A systematic review and meta-analysis”. BMJ Open10 (2019): e028728.
6. Choo CS., et al. “Delayed versus early repair of inguinal hernia in preterm infants: A systematic review and meta-analysis”. Journal of Pediatric Surgery 11 (2022): 527-533.
7. Taverner F., et al. “Perioperative management of infant inguinal hernia surgery a review of the recent literature”. Pediatric Anesthesia 10 (2023): 793-799.
8. Blakely ML., et al. “Effect of early vs late inguinal hernia repair on serious adverse event rates in preterm infants: a randomized clinical trial”. Journal of the American Medical Association12 (2024): 1035-1044.