Inguinal Hernia in Preterm Infants: A Comparative Study of Early Versus Late Surgical Repair

Document Type : Original Article

Authors

Department of Pediatric Surgery, Zagazig University Hospitals, Zagazig, Egypt

10.21608/ejsur.2025.351193.1350

Abstract

Background: Inguinal hernia is a common condition in preterm infants, with an increased risk of complications such as
incarceration and strangulation. The optimal timing of surgical repair, whether early (prior to NICU discharge) or delayed
(after 50 weeks corrected age), remains debated.
Objective: This study aimed to compare the safety and outcomes of early versus late surgical repair of inguinal hernia in
preterm infants.
Patients and Methods: A retrospective cohort study was conducted at Zagazig University Hospitals over a 5-year period,
including 120 preterm infants (< 37 weeks gestation) with inguinal hernia. Patients were divided into two groups: early
repair (n= 60) and late repair (n= 60). Outcomes assessed included serious complications (e.g., respiratory complications,
hernia recurrence, testicular atrophy), hernia incarceration, operative time, and hospital stay. Statistical analysis was
performed to identify significant differences.
Results: The mean age at surgery was 40.62±2.19 weeks for the early group and 56.21±5.16 weeks for the late group.
Early repair was associated with longer hospital stays (4.3±0.1 days vs. 6.4±0.9 hours, p< 0.05) and higher rates of
respiratory complications, including apnea (6.6%) and PICU admission (5%). Hernia recurrence (3.3%) and testicular
atrophy (1.6%) were also noted in the early group. In contrast, the late repair group experienced a higher incidence of
hernia incarceration (10).
Conclusion: Early repair reduces the risk of hernia incarceration but is associated with higher perioperative complications,
including respiratory issues and recurrence. Delayed repair allows for physiological maturation, reducing immediate
complications but increasing the risk of incarceration. Individualized decision-making, considering gestational age and
health status, is crucial. Further multicenter trials are recommended to establish optimal timing for inguinal hernia repair.

Keywords

The Egyptian Journal of Surgery
Volume 44, Issue 3
July 2025
Pages 997-1001

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