Our Summary

This study looked at the best time to perform a common type of surgery (inguinal hernia repair) on premature babies. The researchers wanted to find out if it was better to do the surgery before or after the babies were discharged from the neonatal intensive care unit.

The study involved 338 premature babies with inguinal hernias from 39 hospitals in the US. Half of the children had their surgery before being discharged from the hospital (early repair group), while the other half had their surgery after being discharged and when they were older than 55 weeks from conception (late repair group).

The main goal was to see how many babies had serious complications during the 10-month period after the surgery. They also looked at how many days the babies stayed in the hospital during this time.

The results showed that less babies in the late repair group (18%) had serious complications compared to the early repair group (28%). Additionally, babies in the late repair group generally spent less time in the hospital.

This was especially true for babies born earlier than 28 weeks and those with a lung condition called bronchopulmonary dysplasia.

Based on these findings, the researchers suggested that it may be better to delay the hernia repair surgery until after the babies are discharged from the hospital.

FAQs

  1. What was the main focus of this study on pediatric hernia repair?
  2. What were the results of the study comparing early and late hernia repair in premature babies?
  3. Based on the study, when is the suggested time to perform a hernia repair surgery on premature babies?

Doctor’s Tip

This study suggests that it may be better to delay hernia repair surgery for premature babies until after they are discharged from the hospital. This can help reduce the risk of serious complications and potentially shorten the length of their hospital stay. It is important to discuss the timing of the surgery with your child’s doctor to determine the best course of action for your child’s specific situation.

Suitable For

Pediatric patients, specifically premature babies with inguinal hernias, are typically recommended for pediatric hernia repair. In this study, babies born earlier than 28 weeks and those with bronchopulmonary dysplasia were found to benefit from delaying the surgery until after discharge from the hospital.

Timeline

Before pediatric hernia repair:

  1. Diagnosis of inguinal hernia in a premature baby
  2. Consultation with a pediatric surgeon to discuss treatment options
  3. Preoperative evaluation and preparation for surgery, including scheduling the procedure
  4. Monitoring the baby’s health and growth leading up to the surgery date

After pediatric hernia repair:

  1. Surgery is performed to repair the inguinal hernia
  2. Postoperative recovery period in the hospital, usually lasting a few days
  3. Monitoring for any complications or signs of infection following the surgery
  4. Discharge from the hospital once the baby is stable and able to eat and drink normally
  5. Follow-up appointments with the pediatric surgeon to ensure proper healing and monitor for any long-term issues

Overall, the timeline for a patient undergoing pediatric hernia repair involves a combination of diagnosis, preparation, surgery, recovery, and follow-up care to ensure the best possible outcome for the baby.

What to Ask Your Doctor

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

  1. What is the best timing for my child’s hernia repair surgery?
  2. What are the potential risks and complications associated with pediatric hernia repair?
  3. How experienced are you in performing pediatric hernia repair surgeries?
  4. Will my child need to stay in the hospital after the surgery, and if so, for how long?
  5. What is the expected recovery time for my child after the surgery?
  6. Are there any specific post-operative care instructions or restrictions that I need to follow?
  7. How will my child’s pain be managed after the surgery?
  8. Are there any long-term effects or considerations we should be aware of following the surgery?
  9. How often will my child need follow-up appointments after the surgery?
  10. Are there any alternative treatment options to consider for my child’s hernia?

Reference

Authors: HIP Trial Investigators; Blakely ML, Krzyzaniak A, Dassinger MS, Pedroza C, Weitkamp JH, Gosain A, Cotten M, Hintz SR, Rice H, Courtney SE, Lally KP, Ambalavanan N, Bendel CM, Bui KCT, Calkins C, Chandler NM, Dasgupta R, Davis JM, Deans K, DeUgarte DA, Gander J, Jackson CA, Keszler M, Kling K, Fenton SJ, Fisher KA, Hartman T, Huang EY, Islam S, Koch F, Lainwala S, Lesher A, Lopez M, Misra M, Overbey J, Poindexter B, Russell R, Stylianos S, Tamura DY, Yoder BA, Lucas D, Shaul D, Ham PB 3rd, Fitzpatrick C, Calkins K, Garrison A, de la Cruz D, Abdessalam S, Kvasnovsky C, Segura BJ, Shilyansky J, Smith LM, Tyson JE. Journal: JAMA. 2024 Mar 26;331(12):1035-1044. doi: 10.1001/jama.2024.2302. PMID: 38530261