Objective: Experience in the treatment of inguinal hernias in premature and low-birth-weight children.

Materials and Methods: Inguinal hernia is one of the most common surgical pathologies in premature infants. From 2015 to 2023, at the N.F. Filatov Children's City Clinical Hospital, Department of Surgery for Newborns and Premature Infants, 669 children under 1 year of age were treated, of whom 88 children (13%) were premature: 24 girls and 64 boys. All girls were operated on electively (22 – SEAL- operation, 2 – open repairs); among those operated on, children with ELBW (up to 1000 g) predominated – 11 cases (45.8%), LBW (more than 1500 g) – 7 cases (29.2%), VLBW (1000–1500 g) – 6 cases (25%). The postconceptional age at the time of surgery varied widely regardless of the birth weight category. In patients with ELBW: from 60 to 223 days (mean age 126 ± 53), in children with VLBW – from 87 to 224 days (mean age 131 ± 50), in children with LBW – from 42 to 240 days (mean age 92 ± 69). Among male patients, 60 underwent elective surgery and 4 required emergency syrgery (62 – SAEL- operation, 2 – open repair). Among those operated on, children with ELBW (up to 1000 g) predominated – 25 patients, LBW (more than 1500 g) – 21 patients, VLBW (1000–1500 g) – 18 patients. The age of patients with ELBW was 60–300 days (mean age 172 ± 73), in children with VLBW – from 36 to 270 days (mean age 140 ± 60), in children with LBW – from 60 to 188 days (mean age 92 ± 41). All cases of incarcerated inguinal hernias were registered in boys, which is associated with anatomical and embryological features of the development of the inguinal canal.

Results: The obtained data indicate a predominance of patients with ELBW as a category of children with a high frequency requiring surgical treatment, which emphasizes the need for their early and timely surgical treatment. Also, the significant variability in the timing of surgical intervention reflects an individual approach to the choice of operation time.

Conclusion: SEAL- operation (Subcutaneous Endoscopically Assisted Ligation) is a minimal invasive technique and safe method of surgical treatment of inguinal hernias, also in incarcerated cases, taking into account the clinical condition of the child and concomitant pathology, regardless of gestational age.

TBA