دورية أكاديمية
أعرض في EDS

Immediate Versus Delayed Surgical Management of Infant Cryptorchidism With Inguinal Hernia.

التفاصيل البيبلوغرافية
العنوان: Immediate Versus Delayed Surgical Management of Infant Cryptorchidism With Inguinal Hernia.
المؤلفون: Ramsey WA; DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA. Electronic address: war31@miami.edu., Huerta CT; DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA., Jones AK; University of Miami Miller School of Medicine, Miami, FL, USA., O'Neil CF; DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA., Saberi RA; DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA., Gilna GP; DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA., Lyons NB; DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA., Collie BL; DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA., Parreco JP; Memorial Regional Hospital, Division of Trauma and Surgical Critical Care, Hollywood, FL, USA., Thorson CM; DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA., Sola JE; DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA., Perez EA; DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
المصدر: Journal of pediatric surgery [J Pediatr Surg] 2024 Jan; Vol. 59 (1), pp. 134-137. Date of Electronic Publication: 2023 Sep 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia, PA : Saunders
Original Publication: New York.
مواضيع طبية MeSH: Hernia, Inguinal*/complications , Hernia, Inguinal*/surgery , Hernia, Inguinal*/diagnosis , Cryptorchidism*/complications , Cryptorchidism*/surgery, Infant ; Male ; Humans ; Infant, Newborn ; Retrospective Studies ; Infant, Premature ; Orchiopexy/methods ; Herniorrhaphy/methods
مستخلص: Introduction: Cryptorchidism is commonly treated with orchiopexy at 6-12 months of age, often allowing time for undescended testicle(s) (UT) to descend spontaneously. However, when an inguinal hernia (IH) is also present, some surgeons perform orchiopexy and inguinal hernia repair (IHR) immediately rather than delaying surgery. We hypothesize that early surgical intervention provides no benefit for newborns with both IH and UT.
Methods: The Nationwide Readmissions Database was used to identify newborns with diagnoses of both IH and UT from 2010 to 2014. Patients were stratified by management: IHR performed on initial admission (Repair) or not (Deferral). Demographics, outcomes, and complications were compared. Results were weighted for national estimates.
Results: We analyzed 1306 newborns (64% premature) diagnosed with both IH and UT. IHR was performed at index admission in 30%. Repair was more common in premature babies (43% vs. 8% full-term, p < 0.001) and patients with congenital anomalies (33% vs. 27% without congenital anomaly, p = 0.012). There was no difference in readmission rates. Repair patients had higher rates of orchiectomy than did Deferral. No Deferral patients were readmitted for bowel resection, and <1% were readmitted for orchiectomy or hernia incarceration.
Conclusion: In newborns with UT and IH, immediate repair is not associated with improved outcomes. Even with incarceration on initial presentation, rates of readmission with incarceration or bowel compromise for patients who undergo Deferral of surgery are minimal. Moreover, Repair newborns have higher rates of orchiectomy. We found no benefit to early operative intervention; thus, we recommend waiting until 6-12 months of age to reassess for surgery.
Level of Evidence: Level III TYPE OF STUDY: Retrospective Comparative Study.
Competing Interests: Conflicts of interest None.
(Copyright © 2023. Published by Elsevier Inc.)
فهرسة مساهمة: Keywords: Cryptorchidism; Inguinal hernia; Premature; Undescended testis
تواريخ الأحداث: Date Created: 20231020 Date Completed: 20231218 Latest Revision: 20231218
رمز التحديث: 20231218
DOI: 10.1016/j.jpedsurg.2023.09.021
PMID: 37858390
قاعدة البيانات: MEDLINE
الوصف
تدمد:1531-5037
DOI:10.1016/j.jpedsurg.2023.09.021