Wait Times For Surgical Repair Of Hernias Among Infants And Young Children

Main Category: Pediatrics / Children's Health
Article Date: 05 Nov 2008 - 3:00 PDT

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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. 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.

"Risk of incarceration of inguinal hernia among infants and young children awaiting elective surgery."
Mohammed Zamakhshary, MD MEd, Teresa To, MSc PhD, Jun Guan, MSc and Jacob C. Langer, MD
CMAJ • November 4, 2008; 179 (10). doi:10.1503/cmaj.070923.
Click here to view abstract online

About CMAJ

CMAJ is the leading health sciences journal in Canada. CMAJ is a general medical journal publishing original research and review articles, commentaries and editorials, practice updates, an arts and ideas section and health news. Published continuously since 1911, new issues are uploaded on http://www.cmaj.ca every second Monday at 4:30 p.m. EST/EDT. www.cmaj.ca contains the complete editorial contents of CMAJ, supplemented by a variety of interactive features and additional content.

CMAJ is an open- and free-access journal - there are no author or page charges and access is provided free on the web (HighWire Press), http://www.cmaj.ca without registration. http://www.cmaj.ca has about 1 million requests and 250,000 page views per month. The Journal is part of the PubMed Central collection of journals http://www.pubmedcentral.nih.gov at the National Library of Medicine thus providing a guarantee of permanent archiving and open access. PubMed Central is now processing back issues of CMAJ to 1911.

CMAJ's impact factor - a measure of the scientific importance of articles published - has more than tripled since 1997 and is now 7.1.

The Journal receives about 2000 manuscripts a year (including letters to the editor and news articles). CMAJ's acceptance rate for unsolicited research and review articles is about 12%.

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