A new study suggests that delaying inguinal hernia repair in preterm infants until after NICU discharge results in better outcomes compared with performing repair procedures before discharge.
of preterm infants with inguinal hernia found that performing repair after discharge from the neonatal intensive care unit resulted in less adverse events than procedures prior to discharge.The study compared the safety of repair before discharge from the NICU with repair after discharge and post-55 weeks gestational plus chronological age .
The study randomized 338 infants from 39 US hospitals to early or late repair; of the 320 infants who had the surgery, 86% were male, 30% were Black, and 59% were White. The primary outcome was the occurrence of at least one serious adverse event over the 10-month observation period, including apnea requiring respiratory intervention, intubation for more than 2 days, bradycardia requiring pharmacological intervention, or death.
Secondary outcomes included a total number of days in the hospital, including the initial NICU stay after randomization, postoperative hospitalization, and any inpatient days due to hospital readmission over the course of the following 10-month period.Infants who underwent late repair had a lower probability of having at least one serious adverse event: 28% had at least one adverse event in the early group vs 18% in the late group.
Infants in the late repair group had shorter stays in the NICU after randomization, as well as fewer hospital days following surgery.Hernias resolved spontaneously in 4% of infants in the early repair group and 11% in the late group, which the authors said supports delaying hernia repair.
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