Zhao YZ, Kang HL. Risk factors for recurrence after open neonatal hernia repair: A single-center, retrospective study. World J Gastrointest Surg 2025; 17(5): 103151 [DOI: 10.4240/wjgs.v17.i5.103151]
Corresponding Author of This Article
Hui-Ling Kang, Department of Neonatology, Shijiazhuang Maternal and Child Health Hospital, No. 396 Youyi Street, Qiaoxi District, Shijiazhuang 050000, Hebei Province, China. khl1391366132@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2025; 17(5): 103151 Published online May 27, 2025. doi: 10.4240/wjgs.v17.i5.103151
Risk factors for recurrence after open neonatal hernia repair: A single-center, retrospective study
Yue-Zhi Zhao, Hui-Ling Kang
Yue-Zhi Zhao, Department of Surgical Anesthesia, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050000, Hebei Province, China
Hui-Ling Kang, Department of Neonatology, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050000, Hebei Province, China
Author contributions: Kang HL designed research and analyzed data; Zhao YZ performed research, contributed new reagents or analytic tools, and wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Shiazhuang Maternal and child Health Hospital Institutional Review Board (No. 202123).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Ling Kang, Department of Neonatology, Shijiazhuang Maternal and Child Health Hospital, No. 396 Youyi Street, Qiaoxi District, Shijiazhuang 050000, Hebei Province, China. khl1391366132@163.com
Received: January 10, 2025 Revised: February 26, 2025 Accepted: April 8, 2025 Published online: May 27, 2025 Processing time: 132 Days and 18.3 Hours
Abstract
BACKGROUND
Inguinal and umbilical hernias are common neonatal conditions. Open hernia repair is currently the primary surgical treatment, but postoperative recurrence remains a significant risk.
AIM
To identify the risk factors for recurrence following open neonatal hernia repair.
METHODS
We retrospectively reviewed the data of 56 neonates who underwent open hernia repair at Shijiazhuang Maternal and Child Health Hospital between March 2021 and December 2023. The patients were categorized into recurrence and non-recurrence groups based on their experience of postoperative recurrence. Univariate analysis was performed to examine various factors, and those with P < 0.1 in univariate analysis were included in multivariate logistic regression. Nomogram models were constructed, and their performance was evaluated using receiver operating characteristic curves.
RESULTS
Of the 56 children, 11 (19.64%) experienced postoperative recurrence, whereas the remaining 45 (80.36%) did not. Univariate analysis identified anemia (P = 0.079), persistent postoperative pain (P = 0.049), and low birth weight (P = 0.017) as factors associated with recurrence. Multivariate logistic regression analysis revealed that anemia (P = 0.029), persistent postoperative pain (P = 0.008), and low birth weight (P = 0.009) were independent risk factors for recurrence after open hernia repair in neonates.
CONCLUSION
The risk of recurrence after open hernia repair should be closely monitored in neonates with low birth weight, anemia, and persistent postoperative pain.
Core Tip: This retrospective study investigated recurrence after open neonatal hernia repair and identified low birth weight, anemia, and persistent postoperative pain as independent risk factors. Notably, persistent postoperative pain - a previously overlooked factor - was revealed as a novel predictor of recurrence. A nomogram integrating these variables demonstrated excellent predictive power (area under the curve = 0.875), offering clinicians an accessible tool to identify high-risk neonates and tailor postoperative care to reduce recurrence and improve prognosis.
