Ann Surg Treat Res.  2023 May;104(5):296-301. 10.4174/astr.2023.104.5.296.

Optimal timing for inguinal hernia repair in premature infants: surgical issues for inguinal hernia in premature infants

  • 1Department of Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
  • 2Department of Pediatric Surgery, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
  • 3Department of Surgery, Inje University Busan Paik Hospital, Busan, Korea
  • 4Division of Pediatric Surgery, Department of Surgery, Chonnam National University Hospital, Gwangju, Korea
  • 5Department of Pediatric Surgery, Keimyung University Dongsan Hospital, Daegu, Korea
  • 6Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea


We analyzed the timing of inguinal hernia repair in premature infants in the neonatal intensive care unit (NICU) considering recurrence, incarceration, and other complications.
In this multicenter retrospective review, premature infants (<37 weeks) in the NICU diagnosed with inguinal hernia between 2017 and 2021 were segregated into 2 groups based on the timing of inguinal hernia repair.
Of 149 patients, 109 (73.2%) underwent inguinal hernia repair in the NICU and 40 (26.8%) after discharge. Preoperative incarceration did not differ, but complications with recurrence and postoperative respiratory insufficiency were higher in the NICU group (11.0% vs. 0%, P = 0.029; 22.0% vs. 5.0%, P = 0.01). Multivariate analysis showed that the significant factors affecting recurrence were preoperative ventilator dependence and body weight of <3,000 g at the time of surgery (odds ratio [OR], 16.89; 95% confidence interval [CI], 3.45–82.69; P < 0.01 and OR, 9.97; 95% CI, 1.03–95.92; P = 0.04).
Our results suggest that when premature infants are diagnosed with inguinal hernia in the NICU, inguinal hernia repair after discharge may decrease the odds of recurrence and postoperative respiratory insufficiency. In patients who have difficulty delaying surgery, it is thought that surgery should be performed carefully in a ventilator preoperatively or weighed <3,000 g at the time of surgery.


Inguinal hernia; Herniorrhaphy; Premature infant; Respiratory insufficiency


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