Our Summary

This research paper looks at whether immediate repair of an incarcerated inguinal hernia (a type of hernia that can’t be manually pushed back into place) in children is always necessary, or if it can be safely delayed. The study used data from a national database to identify children under 18 with this condition from 2010 to 2014, and analyzed different outcomes based on whether they had immediate surgery or a delayed one.

The results showed that the majority of patients (88%) had immediate surgery. However, the study found that for those who had delayed surgery, the rates of readmission to the hospital within a year were roughly the same as for those who had immediate surgery. However, there was a higher rate of readmission within the first 30 days for those who delayed surgery.

On the positive side, those who delayed surgery had lower rates of needing to have a testicle removed (orchiectomy), wound infections and other infections. They found no difference between the two groups in terms of other complications such as needing to have part of the bowel or an ovary removed, testicular atrophy, blood poisoning, or pneumonia. They did find that 3% of those who delayed surgery were readmitted with a hernia that had become incarcerated again.

In conclusion, the paper suggests that delaying surgery in some cases may be a valid approach, but more research is needed to identify which patients are good candidates for this. The authors also note that their study didn’t include data on surgeries that took place outside of a hospital setting.

FAQs

  1. What is an incarcerated inguinal hernia and how was it studied in this research?
  2. What were the findings of the study on immediate versus delayed surgery for incarcerated inguinal hernia in children?
  3. What are the potential benefits of delaying surgery for an incarcerated inguinal hernia, according to this study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hernia repair is that while immediate surgery is often recommended for an incarcerated inguinal hernia, in some cases delaying surgery may be a safe option. It is important to discuss the risks and benefits with your healthcare provider to determine the best course of action for your specific situation.

Suitable For

Typically, patients who are recommended for hernia repair are those with symptoms such as pain, discomfort, or a visible bulge. In the case of an incarcerated inguinal hernia, immediate repair is often recommended to prevent complications such as bowel obstruction or strangulation. However, as seen in the study mentioned above, delaying surgery may be a viable option for some patients, especially if they are at lower risk for complications. Ultimately, the decision to undergo hernia repair should be based on a thorough evaluation by a healthcare provider.

Timeline

Timeline of what a patient experiences before and after hernia repair:

Before hernia repair:

  1. Patient may experience pain or discomfort in the affected area, often worsening with physical activity or straining.
  2. Patient may notice a bulge or lump in the groin or abdominal area.
  3. Patient may have difficulty with bowel movements or urination.
  4. Patient may consult with a healthcare provider who will diagnose the hernia through physical examination or imaging tests.
  5. Patient may undergo pre-operative tests and evaluations to ensure they are healthy enough for surgery.

After hernia repair:

  1. Patient will undergo the hernia repair surgery, either through open surgery or laparoscopic surgery.
  2. Patient will be monitored in the recovery room immediately after surgery for any complications.
  3. Patient may experience some pain, swelling, and bruising in the surgical area post-operatively.
  4. Patient will be advised on post-operative care, including wound care, activity restrictions, and pain management.
  5. Patient will have follow-up appointments with their healthcare provider to monitor their healing progress and address any concerns.
  6. Patient will gradually resume normal activities and may be advised to participate in physical therapy to strengthen the abdominal muscles.
  7. Patient will be advised on how to prevent future hernias, such as maintaining a healthy weight and avoiding heavy lifting.
  8. Patient may experience a full recovery within a few weeks to a few months, depending on the type of surgery and individual healing process.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hernia repair include:

  1. What type of hernia do I have and what are the treatment options available?
  2. Is surgery necessary for my hernia, or can it be managed with other non-surgical methods?
  3. What are the risks and benefits of undergoing hernia repair surgery?
  4. What is the success rate of hernia repair surgery and what is the recovery process like?
  5. Are there any specific complications or side effects I should be aware of after the surgery?
  6. How long will it take for me to fully recover and return to normal activities?
  7. Are there any alternative treatments or approaches that I should consider?
  8. What are the potential long-term effects of not undergoing surgery for my hernia?
  9. How experienced are you in performing hernia repair surgeries, and what is your success rate?
  10. Are there any specific factors about my health or medical history that may affect the outcome of the surgery?

Reference

Authors: Ramsey WA, Huerta CT, O’Neil CF Jr, Taylor RR, Saberi RA, Gilna GP, Collie BL, Lyons NB, Parreco JP, Thorson CM, Sola JE, Perez EA. Journal: J Surg Res. 2024 Mar;295:641-646. doi: 10.1016/j.jss.2023.11.059. Epub 2023 Dec 15. PMID: 38103321