World journal of surgery
-
World journal of surgery · Sep 1992
Optimal timing of elective indirect inguinal hernia repair in healthy children: clinical considerations for improved outcome.
Experience with several incarcerations that resulted in emergent surgery for children with known indirect inguinal hernias prompted this review to determine if there is an optimal time after hernia diagnosis during which elective repair should be undertaken to avoid incarceration. Over a 30 month period, 228 children less than 10 years of age underwent 303 indirect inguinal hernia repairs. They were analyzed for age, sex, interval between diagnosis and repair, predisposing conditions, major complications, and length of hospitalization. ⋯ Compared to children who underwent repair of a reducible indirect inguinal hernia, those with incarceration were more likely (p less than 0.05): 1) to have major complications (11% vs 0.6%), 2) to have a shorter interval between diagnosis and repair (26 vs 49 days), 3) to be younger (7.5 vs 25.6 mos), and 4) to require greater than 24 hours of hospitalization. Had children with reducible incarcerated indirect inguinal hernia been hospitalized and undergone repair 24 to 48 hours later, 83% of subsequent incarcerations would have been prevented. Furthermore, this experience supports the recommendation that for healthy children less than 10 years of age, indirect inguinal hernia repair should be performed on a semi-elective basis within 7 days of diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)