Case-Based Journal Review: Inguinal Hernia 2025

In the JAMA trial of 308 preterm infants, 44 patients (28%) in the early repair group had at least one serious adverse event versus 27 patients (18%) in the late repair group

Recurrence rate after inguinal hernia repair in the trial was less than 1%

Incarceration rate in the late repair group was around 4%

In the early repair group, 4% of hernias resolved spontaneously; in the late repair group, 11% resolved spontaneously

One patient in the trial had a bowel injury during hernia repair

There was zero incidence of bowel loss in the trial

The trial showed more reintubations and more apnea in the early repair group

The JAMA trial was terminated early, had low recruitment rate, and ended up with less statistical power than initially calculated

In the Dutch one-stop surgery study of 91 patients (54 one-stop, 37 usual care), all but one of the one-stop surgery patients were discharged home on the day of surgery

Post-operative complication and recurrence rates did not differ between one-stop surgery and usual care patients in the Dutch study

General satisfaction and inclusion of family were higher after one-stop surgery experience

There was no diagnostic uncertainty in the one-stop surgery program

A recent Surgery journal article found that routine post-operative visits alter management in less than 1% of cases for routine pediatric surgical conditions including circumcision, orchiopexy, and inguinal hernia

When facing medical problems with low risk of complications, family satisfaction becomes a surrogate for quality

In the multi-institutional patent processus vaginalis study, 246 eligible infants under 4 months with PPV found at pyloromyotomy were enrolled at 8 children's hospitals, with 85% responding to at least one annual follow-up

Of the 246 infants with patent processus vaginalis, two had inguinal hernia repair for symptomatic hernia, one had orchiopexy and incidental inguinal hernia repair, for a total of 3 hernia repairs

The presence of patent processus vaginalis at the time of pyloromyotomy was common, but the need for hernia repair was around 1% in the first year of follow-up

A Mayo Clinic study by Ben Zendejas showed contralateral hernia occurrence after a 50-year follow-up period