Department of Surgery, University of Virginia School of Medicine, 1215 Lee St, Charlottesville, VA, 22908, USA.
University of Virginia School of Medicine, Charlottesville, VA, USA.
Pediatr Surg Int. 2021 Sep;37(9):1295-1301. doi: 10.1007/s00383-021-04938-7. Epub 2021 Jun 6.
The incidence of inguinal hernias in premature infants is approximately 30%. Due to concerns about a high risk of incarceration, early repair is commonly performed. We present a series of patients whose families opted to delay repair until after 55 weeks corrected gestational age (GA) and experienced safe clinical regression of their hernias.
Between June 2015 and July 2020, premature infants (< 37 weeks GA) diagnosed with inguinal hernias on physical examination were identified. Families of eligible infants were offered either immediate or delayed repair after 55 weeks corrected GA. Infants whose families elected to delay were followed until their hernia(s) clinically regressed, or until older than 55 weeks.
Families of 68 infants consented to delay repair. 23 infants (33.8%) had hernias that clinically regressed at median follow up from diagnosis of 14.1 weeks. Univariate analysis demonstrated female sex as a significant predictor of hernia clinical regression (OR: 3.08; p = 0.046). Of the 45 infants who underwent repair, 84.4% safely progressed to 55 weeks corrected GA prior to.
Delaying inguinal hernia repair in this series of premature infants until after 55 weeks corrected GA revealed that one third of hernias, especially in females, safely regressed upon follow-up examination.
早产儿腹股沟疝的发病率约为 30%。由于担心嵌顿风险高，通常会进行早期修复。我们介绍了一系列患者，其家属选择在纠正胎龄 55 周后延迟修复，并经历了疝的安全临床消退。
在 2015 年 6 月至 2020 年 7 月期间，通过体格检查发现患有腹股沟疝的早产儿(<37 周 GA)。符合条件的婴儿的家属可选择在纠正胎龄 55 周后立即或延迟修复。选择延迟修复的婴儿将被随访，直到他们的疝自行消退，或直到他们超过 55 周。
有 68 名婴儿的家属同意延迟修复。中位数随访 14.1 周后，有 23 名婴儿（33.8%）的疝临床消退。单因素分析显示，女性是疝临床消退的显著预测因素（OR：3.08；p=0.046）。在 45 名接受修复的婴儿中，84.4%在<55 周纠正胎龄前安全进展。
在本系列早产儿中，将腹股沟疝修复延迟至纠正胎龄 55 周后，发现三分之一的疝，特别是女性的疝，在随访检查中安全消退。
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