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J Pediatr Surg. 2011 Nov;46(11):2151-6. doi: 10.1016/j.jpedsurg.2011.06.014.

Fifty-three-year experience with pediatric umbilical hernia repairs.

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1
Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.

Abstract

PURPOSE:

The aim of this study was to evaluate the long-term surgical and patient-reported outcomes of pediatric umbilical hernia (UH) repairs.

METHODS:

A retrospective review of all children (<18 years old) who underwent UH repair at Mayo Clinic-Rochester in the last half century was done. Follow-up was obtained by mailed survey.

RESULTS:

From 1956 to 2009, 489 children (boys, 251; girls, 238) underwent a primary UH repair. The mean age was 3.9 years (range, 0.01-17.8 years). Complicated UHs that required emergent repair (n = 34, or 7%) included recurrent incarceration (22), enteric fistula (7), strangulation (4), and evisceration (1). Mean UH size was 1.3 cm (range, 0.2-7.0 cm), varying by operative indication (1.0 cm emergent vs 1.5 cm elective repairs, P = .008) and decade of repair (2.2 cm, 1950s-60s vs 1.3 cm, 1990s-2000s; P = .001). Postoperative morbidity (2%) consisted of superficial wound infection (7), hematoma (3), and seroma (1). With a 66% survey response rate and mean follow-up of 13.0 years (range, 0-53.8 years), 8 (2%) patients experienced a recurrence. Most patients reported satisfaction (90%) with the cosmetic appearance of their umbilicus and are pain free (96%).

CONCLUSION:

Pediatric UH repairs have low morbidity and recurrence rates. Most patients are satisfied and pain free. Importantly, complicated UHs were more likely to be associated with smaller defects; therefore, parental counseling for signs of incarceration is recommended even in small defects.

PMID:
22075348
DOI:
10.1016/j.jpedsurg.2011.06.014
[Indexed for MEDLINE]
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