Does bronchopulmonary dysplasia change the postoperative outcome of herniorrhaphy in premature babies?

Background: Inguinal hernia is a common surgical condition in premature neonates. Because of physiological immaturity, they can present with lung-related diseases, such as bronchopulmonary dysplasia (BPD), which may influence the time for operation and the postoperative outcome after hernia repair. The aim of this study was to analyze the role of BPD in the outcome of premature infants who underwent herniorrhaphy.

Methods: Fifty-two premature infants who underwent hernia repair from 1996 to 2004 at CAISM-UNICAMP were included in this study. Seventeen babies had BPD and 35 did not. The features reviewed included: (i) associated preoperative morbidity; (ii) birth data and the hernia; and (iii) hernia diagnosis, surgery and postoperative outcome data. Three sets of analysis were undertaken. The first compared features with and without BPD. The second was an univariate analysis to detect associations between those features and postoperative complications. Finally, a multivariate analysis to determine the effect of BPD when adjusted for other factors.

Results: Some features were different between the studied groups, such as birth weight, age at herniorrhaphy and time of preoperative mechanical ventilation. There was no statistical difference in weight at surgery, duration of postoperative ventilation and weight at discharge between those with BPD and those without. Univariate and multivariate analysis found no association between different studied variables, including BPD, and incidence of postoperative respiratory complications.

Conclusion: These data suggest that all premature infants, with or without BPD, should be treated with equal concern regarding the possibility of postoperative pulmonary complications.