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<p>There is conflicting evidence regarding the best timing for inguinal hernia repair in preterm infants. To clarify this uncertainty, we performed a systematic review and meta-analysis to compare outcomes for preterm infants who underwent hernia repair either before or after hospital discharge. We searched PubMed, Embase and Cochrane databases through April 2024 for studies comparing early versus late inguinal hernia repair in preterm infants. We computed odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Heterogeneity was assessed using I2 statistics. Nine studies and 3213 patients were included. Among them, 2024 (62.9%) underwent early inguinal hernia repair. Early repair was associated with a significant reduction in incarceration development (OR 0.44; 95% CI 0.35–0.57; <i>p</i> &lt; 0.001; I<sup>2</sup> = 0) compared with late repair. Conversely, preterm infants who underwent late inguinal hernia repair had significantly lower odds of recurrence (OR 4.18; 95% CI 1.50–11.67; <i>p</i> = 0.006; I<sup>2</sup> = 0), and respiratory complications (OR 3.91; 95% CI 2.30–6.65; <i>p</i> &lt; 0.001; I<sup>2</sup> = 42) compared with early inguinal hernia repair. Late inguinal hernia repair was associated with fewer negative outcomes in preterm infants compared with the early repair strategy. These findings support postponing inguinal repair until after the initial hospital discharge.</p> Graphical Abstract <p></p>

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Early vs. Late Inguinal Hernia Repair in Preterm Infants: An Updated Systematic Review and Meta-Analysis with Trial Sequential Analysis

  • 期刊论文

  • 发表日期：

    2025年1月22日

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  • Ana Clara Felix de Farias Santos,
  • Fernanda Valeriano Zamora,
  • Lorhayne Kerley Capuchinho Scalioni Galvão,
  • Nicole dos Santos Pimenta,
  • João Pedro Costa Esteves Almuinha Salles,
  • Andres Villca Zamora,
  • Renan Carlo Colombari

摘要

There is conflicting evidence regarding the best timing for inguinal hernia repair in preterm infants. To clarify this uncertainty, we performed a systematic review and meta-analysis to compare outcomes for preterm infants who underwent hernia repair either before or after hospital discharge. We searched PubMed, Embase and Cochrane databases through April 2024 for studies comparing early versus late inguinal hernia repair in preterm infants. We computed odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Heterogeneity was assessed using I2 statistics. Nine studies and 3213 patients were included. Among them, 2024 (62.9%) underwent early inguinal hernia repair. Early repair was associated with a significant reduction in incarceration development (OR 0.44; 95% CI 0.35–0.57; p < 0.001; I2 = 0) compared with late repair. Conversely, preterm infants who underwent late inguinal hernia repair had significantly lower odds of recurrence (OR 4.18; 95% CI 1.50–11.67; p = 0.006; I2 = 0), and respiratory complications (OR 3.91; 95% CI 2.30–6.65; p < 0.001; I2 = 42) compared with early inguinal hernia repair. Late inguinal hernia repair was associated with fewer negative outcomes in preterm infants compared with the early repair strategy. These findings support postponing inguinal repair until after the initial hospital discharge.

Graphical Abstract