Effect of Early vs Late Inguinal Hernia Repair on Serious Adverse Event Rates in Preterm Infants

Inguinal hernias are very common in preterm infants, but the optimal timing for surgical repair is still debated due to the associated risks. A recent European study demonstrated an important variation in practice patterns, with 56% of surgeons recommending surgery before discharge. This article. Entitled Effect of Early versus Late Inguinal hernia repair on Serious adverse event rates in Preterm infants, a randomized clinical Trial was published in JAMA 2024. The authors assessed if the timing of inguinal hernia repair influenced the likelihood of serious adverse events in preterm infants. This study involved 338 preterm infants diagnosed with inguinal hernias before their initial hospital stay. They were randomly assigned to either early repair before NICU discharge, or late repair after NICU discharge. The primary outcome measured was the occurrence of any of the predefined serious adverse events over a 10-month period, including death, hernia complications, and respiratory and cardiovascular morbidity. The study found that late repair significantly reduced the rate of serious adverse events, with only 18% in the late repair group compared to 28% in the early repair group. The late repair group also experienced a 3 day reduction in length of stay. Applying these results, delaying inguinal hernia repair until after NICU discharge, might be safer for preterm infants, potentially reducing the risk of serious complications.