Surgical practice and outcome in 711 neonates and infants undergoing hernia repair in a large multicenter RCT: Secondary results from the GAS Study

GAS Consortium

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The GAS study is an international RCT to evaluate neurodevelopmental outcome comparing general plus regional anesthesia versus regional anesthesia alone in 722 neonates and infants who had inguinal hernia repair up to 60 weeks of postmenstrual age. This paper comprises a secondary descriptive analysis of hernias, aspects of surgery and outcomes. Methods: The incidence of unilateral and bilateral hernias, side preponderance, predictive factors for bilateral hernias and surgical approaches were collated. Follow-up outcome data were examined at 2 years. Results: Of 711 eligible patients, there were 679 with hernia data showing that 321 hernias were right-sided, 190 left and 168 bilateral. Male to female ratio was 5:1. Of those with unilateral hernias, 25.8% underwent contralateral exploration and in these cases a patent processus vaginalis was found in 68.9%. Bilateral hernias were more common in younger and female patients. At 2 years there was a recurrence rate of 0.99% and in 2.7% of patients a hernia was evident on the contralateral side (metachrony), and this was unrelated to the anesthesia technique. Conclusions: Bilateral hernias are associated with lower gestational age at birth and female gender. There was a low incidence of complications and the anesthesia technique did not affect surgical outcome. Level of evidence: Level 1 evidence from prospective treatment study.

Original languageEnglish (US)
Pages (from-to)1643-1650
Number of pages8
JournalJournal of Pediatric Surgery
Volume53
Issue number9
DOIs
StatePublished - Sep 1 2018

Fingerprint

Herniorrhaphy
Hernia
Newborn Infant
Conduction Anesthesia
Anesthesia
Inguinal Hernia
Incidence
Gestational Age
Parturition
Prospective Studies
Recurrence

Keywords

  • Anesthesia
  • Infant
  • Inguinal hernia repair
  • Neonate
  • Outcome

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study
  • Randomized Controlled Trial

Cite this

Surgical practice and outcome in 711 neonates and infants undergoing hernia repair in a large multicenter RCT : Secondary results from the GAS Study. / GAS Consortium.

In: Journal of Pediatric Surgery, Vol. 53, No. 9, 01.09.2018, p. 1643-1650.

Research output: Contribution to journalArticle

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title = "Surgical practice and outcome in 711 neonates and infants undergoing hernia repair in a large multicenter RCT: Secondary results from the GAS Study",
abstract = "Background: The GAS study is an international RCT to evaluate neurodevelopmental outcome comparing general plus regional anesthesia versus regional anesthesia alone in 722 neonates and infants who had inguinal hernia repair up to 60 weeks of postmenstrual age. This paper comprises a secondary descriptive analysis of hernias, aspects of surgery and outcomes. Methods: The incidence of unilateral and bilateral hernias, side preponderance, predictive factors for bilateral hernias and surgical approaches were collated. Follow-up outcome data were examined at 2 years. Results: Of 711 eligible patients, there were 679 with hernia data showing that 321 hernias were right-sided, 190 left and 168 bilateral. Male to female ratio was 5:1. Of those with unilateral hernias, 25.8{\%} underwent contralateral exploration and in these cases a patent processus vaginalis was found in 68.9{\%}. Bilateral hernias were more common in younger and female patients. At 2 years there was a recurrence rate of 0.99{\%} and in 2.7{\%} of patients a hernia was evident on the contralateral side (metachrony), and this was unrelated to the anesthesia technique. Conclusions: Bilateral hernias are associated with lower gestational age at birth and female gender. There was a low incidence of complications and the anesthesia technique did not affect surgical outcome. Level of evidence: Level 1 evidence from prospective treatment study.",
keywords = "Anesthesia, Infant, Inguinal hernia repair, Neonate, Outcome",
author = "{GAS Consortium} and Nicola Disma and Davinia Withington and McCann, {Mary Ellen} and Hunt, {Rodney Wayne} and Arnup, {Sarah Jane} and Francesca Izzo and {de Graaff}, {Jurgen C.} and Girolamo Mattioli and Neil Morton and Geoff Frawley and Andrew Davidson and Anne Lynn and Peter Szmuk and Thomas, {Joss J} and Philip Ragg and {Pini Prato}, Alessio",
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T1 - Surgical practice and outcome in 711 neonates and infants undergoing hernia repair in a large multicenter RCT

T2 - Secondary results from the GAS Study

AU - GAS Consortium

AU - Disma, Nicola

AU - Withington, Davinia

AU - McCann, Mary Ellen

AU - Hunt, Rodney Wayne

AU - Arnup, Sarah Jane

AU - Izzo, Francesca

AU - de Graaff, Jurgen C.

AU - Mattioli, Girolamo

AU - Morton, Neil

AU - Frawley, Geoff

AU - Davidson, Andrew

AU - Lynn, Anne

AU - Szmuk, Peter

AU - Thomas, Joss J

AU - Ragg, Philip

AU - Pini Prato, Alessio

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N2 - Background: The GAS study is an international RCT to evaluate neurodevelopmental outcome comparing general plus regional anesthesia versus regional anesthesia alone in 722 neonates and infants who had inguinal hernia repair up to 60 weeks of postmenstrual age. This paper comprises a secondary descriptive analysis of hernias, aspects of surgery and outcomes. Methods: The incidence of unilateral and bilateral hernias, side preponderance, predictive factors for bilateral hernias and surgical approaches were collated. Follow-up outcome data were examined at 2 years. Results: Of 711 eligible patients, there were 679 with hernia data showing that 321 hernias were right-sided, 190 left and 168 bilateral. Male to female ratio was 5:1. Of those with unilateral hernias, 25.8% underwent contralateral exploration and in these cases a patent processus vaginalis was found in 68.9%. Bilateral hernias were more common in younger and female patients. At 2 years there was a recurrence rate of 0.99% and in 2.7% of patients a hernia was evident on the contralateral side (metachrony), and this was unrelated to the anesthesia technique. Conclusions: Bilateral hernias are associated with lower gestational age at birth and female gender. There was a low incidence of complications and the anesthesia technique did not affect surgical outcome. Level of evidence: Level 1 evidence from prospective treatment study.

AB - Background: The GAS study is an international RCT to evaluate neurodevelopmental outcome comparing general plus regional anesthesia versus regional anesthesia alone in 722 neonates and infants who had inguinal hernia repair up to 60 weeks of postmenstrual age. This paper comprises a secondary descriptive analysis of hernias, aspects of surgery and outcomes. Methods: The incidence of unilateral and bilateral hernias, side preponderance, predictive factors for bilateral hernias and surgical approaches were collated. Follow-up outcome data were examined at 2 years. Results: Of 711 eligible patients, there were 679 with hernia data showing that 321 hernias were right-sided, 190 left and 168 bilateral. Male to female ratio was 5:1. Of those with unilateral hernias, 25.8% underwent contralateral exploration and in these cases a patent processus vaginalis was found in 68.9%. Bilateral hernias were more common in younger and female patients. At 2 years there was a recurrence rate of 0.99% and in 2.7% of patients a hernia was evident on the contralateral side (metachrony), and this was unrelated to the anesthesia technique. Conclusions: Bilateral hernias are associated with lower gestational age at birth and female gender. There was a low incidence of complications and the anesthesia technique did not affect surgical outcome. Level of evidence: Level 1 evidence from prospective treatment study.

KW - Anesthesia

KW - Infant

KW - Inguinal hernia repair

KW - Neonate

KW - Outcome

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