EN
TÜRKÇE
Poster - 341
Inguinal Hernia in Newborns – Can you predict the best treatment path?
Silviana Ribeiro 1, Carolina Soares-Aquino 1, Leonor Carmo 1, Henrique Soares 2, Mariana Borges-Dias 1
1 Department of Pediatric Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal
2 Neonatal Intensive Care Unit, Centro Hospitalar Universitário de São João, Porto, Portugal
Purpose: Inguinal hernia is a common condition requiring surgical repair in children. In preterm (PT) infants, incidence can reach 20%, mostly due to birth before embryological closure of the processus vaginalis. Despite a frequently performed procedure, the ideal approach and surgical timing remain uncertain, reflected by significant variation in practice and anaesthesia-related concerns. We aimed to evaluate predicting factors of optimal inguinal hernia repair (IHR) timing and outcome.
Methods: We retrospectively analysed neonates and PT diagnosed with inguinal hernia during neonatal intensive care unit (NICU) admission, over 14 years. Patients were excluded if data was incomplete or evaluation was not conducted by a paediatric surgeon. Variables collected were: Gestational age, sex, congenital anomalies, age and symptoms at diagnosis, laterality, ultrasound use and concordance, surgery timing (NICU/post-NICU), simultaneous procedures, spontaneous resolution and outcomes.
Results: Seventy patients were included; 84% were male. Median gestational age was 29 weeks, and congenital anomalies were present in 46%. Diagnosis occurred at a median of 46.5 days. Ultrasound was performed in 60% and concordance with clinical findings occurred in 50%. Surgical repair was executed in 73%: 33 cases during NICU stay and 19 post-NICU. Thirteen patients had spontaneous resolution, of which 12 (92%) were PT. Five patients were lost to follow-up. Contralateral repair rates were similar. No clinical variables were significant predictors of timing of surgery (p > .05). Regarding outcomes, combined adverse results (surgical complications and recurrence) were significantly more frequent when NICU repair (p = .0208).
Conclusion: No clear predictors guide timing of IHR in newborns. While prompt repair is often necessary, it may carry not only higher anaesthesiologic risk but also adverse surgical outcomes. Spontaneous resolution should not be overlooked in selected cases, especially in PT infants.