Wait times for surgical repair of hernias among infants and young children

November 3, 2008

Longer wait times for surgical repair of inguinal hernias in infants and young children under the age of 2 were associated with more emergency department visits and a greater risk of incarcerated hernia, found a study published in CMAJ http://www.cmaj.ca/press/pg1001.pdf. There are few studies on wait times for surgery in children as most focus on adults.

The study found that the risk of incarceration doubles with a wait time of 35 days compared with a wait time of 14 days, and that 11.9% of children waiting for surgery developed incarcerated hernias.

Hernias can present with vomiting, lack of bowel movements and other symptoms, sending families to emergency rooms. If left untreated, incarcerated hernias can cause serious health problems.

This longitudinal cohort study of almost 1100 infants and children under the age of 2 was conducted by a team of researchers from The Hospital for Sick Children (Sick Kids) and the Institute of Evaluative Sciences in Toronto.

"Our data support a recommendation that all inguinal hernias in infants and young children should be repaired within 14 days after surgical consultation," conclude Dr. Jacob Langer and coauthors.

In a related commentary, Dr. Geoffrey Blair from British Columbia Children's Hospital and the University of British Columbia suggests "infants with inguinal hernias could be appropriately stratified into urgent, less urgent and even "wait-and-see" groups, which might offer a more effective strategy to manage the surgical needs of this population." He points out that children have been largely ignored in the debate over surgical wait times in Canada.

Source: Canadian Medical Association Journal