Assessment of the delayed repair of uncomplicated inguinal hernias in infants

Abstract

Background: Potential strangulation of infant inguinal hernias is the main indication for their urgent repair. Lack of theatre time delays repair and  prolongs hospitalisation. We report a series of patients with uncomplicated hernias who were discharged home to have their elective surgery at a later  stage and assessed the outcomes of this approach.

Methods: A retrospective audit was performed of all infants with an inguinal hernia from January 2010 to June 2015. Incomplete records and infants  operated after their first birthday were excluded. Two groups were identified; immediate surgery for infants with uncomplicated hernias, and delayed  surgery for infants with uncomplicated hernias. Incarceration/ strangulation rates in the interim period were documented for the delayed group, and  comparison made between the groups regarding perioperative and anaesthetic complications and length of postoperative hospital stay.

Results: The mean time delay between diagnosis and repair was 8.78 weeks. None of the hernias in the delay group strangulated while awaiting repair.  There was no significant difference in the perioperative complications between the two groups. Out of the 70 cases in the immediate repair group, there  was 7 (10%) surgical and 4 (5.7%) anaesthetic complications. The delayed group (169 infants) had 8 (4.7%) surgical and 6 (3.6%) anaesthetic complications.  The incarceration rate after being discharged home was 4.1%. This group of infants had no anaesthetic or surgical complications. Length  of hospital stay postoperatively was 1.43 days in the immediate group and 1.3 in the delayed group (p = .485).

Conclusion: Delayed repair, up to 2 months later, for uncomplicated infant hernia carries a small risk of incarceration but does not increase the rate of  strangulation or other complications.