Risk of incarceration in children with inguinal hernia: a systematic review.
Hernia
; 23(2): 245-254, 2019 04.
Article
in En
| MEDLINE
| ID: mdl-30637615
ABSTRACT
BACKGROUND:
Surgical repair is recommended for all children with inguinal hernia due to fear of incarceration. The aim of this study was to assess the risk of incarceration and strangulation of inguinal hernias in children treated with delayed surgery or no surgery.METHODS:
Systematic searches were conducted in three databases. We included studies reporting on children with inguinal hernia, with the majority ≤ 10 years old. The interventions were non-acute inguinal hernia surgery or no surgery. The main outcomes were incarceration and strangulation. Secondary outcomes were postoperative complications. Randomized controlled trials, non-randomized controlled trials, and observational studies were included.RESULTS:
We included 22 studies with 14,959 children. All studies reported on elective repairs. None of the studies specifically reported on watchful waiting. Of the studies reporting wait time as mean or median, the median wait time was 46 days (range 1-552). The crude incarceration rate across the included studies was 7% for all children and 11% for preterm children. The testicular atrophy rate was 1% and the recurrence rate was 1%.CONCLUSIONS:
The risk of incarceration in children awaiting inguinal hernia surgery is substantial. In general, we cannot support delaying surgery unnecessarily. However, there may be benefits of delaying surgery in individual cases. In such cases, the surgeon should assess if the benefits may overrule the risk of incarceration.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hernia, Inguinal
/
Intestinal Obstruction
Type of study:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Limits:
Child
/
Child, preschool
/
Humans
/
Infant
/
Male
/
Newborn
Language:
En
Journal:
Hernia
Journal subject:
GASTROENTEROLOGIA
Year:
2019
Type:
Article
Affiliation country:
Denmark