Original ArticleIncisional hernia in pediatric surgery - experience at a single UK tertiary centre

AimsIncisional hernia (IH) is a recognized complication of open and laparoscopic visceral surgery, with reported rates of 10-50% in adult surgical literature. There is a paucity of data relating to incisional hernias in children. The aim of our study was to analyze the incidence and treatment of IH in children.MethodsRetrospective review of all patients admitted for incisional hernia repair at a tertiary pediatric surgical centre in the UK more than a 7-year period was performed. Data collected included age at initial surgery, time to IH repair, and type of IH repair and postoperative complications.ResultsTwenty one patients (14 male) underwent IH repair during the study period. The incidence of IH among children who had primary abdominal surgery in our institution less than the age of 6 months was 2.3%. Median age at repair was 7.9 months (range: 18 days-5 years). Median time from primary surgery to diagnosis of IH was 2 months (range 0 day-3 years), with 81% (17/21) diagnosed within 1 year of the preceding abdominal procedure. The most common pathology necessitating the primary operative procedure was necrotising enterocolitis (n = 9) in babies of gestational age less than 30 weeks.The highest rates of IH were noted in infants following closure of stoma (7.5%) and pyloromyotomy (2.52%). Primary closure was undertaken in all cases. Two children had recurrence of IH, one of which underwent surgical repair.ConclusionsIncidence of IH in children is low but significant. IH was most commonly diagnosed following closure of stoma for NEC in this study.