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Question:
My preemie son was born May of 2001. He was supposed to be born July of 2001. I just found out that he has a umbilical hernia that needs to be operated on this month (August). Of course I am very worried because he is now only close to 10 pounds in weight. I would like to know what the rate of survival for him from this opperation will be. Please be truthful with me, for the truth is what I really seek in this matter. Thank you so much for your time in this matter.
Noddee1
Answer:
Thank you for your inquiry. An umbilical hernia is a common paediatric surgical condition, and while it a little more common in premature babies is not an unlikely finding in any baby. Most will close on their own without surgery, > 95% by the time the child is 5 years old, and nearly of all the rest by puberty. The time it takes for the hernia to resolve spontaneously logically depends on the size of the deficit in the abdominal wall; hernias less than 0.5 cm in diameter generally close by age 2. If an umbilical hernia is still present after puberty it will probably not close on its own. The reason to operate rather than to wait is in case a loop of bowel comes out of abdominal cavity and is then 'trapped' in the hernia sac, causing obstruction in the bowel, and ompromising the blood supply in the bowel wall. That said, this rarely occurs in umbilical hernias, so many parents and surgeon wait for the repair until the baby is older and well able to cope with surgery. The corollary is of course that while waiting for the baby to grow older and 'bigger' and more able to cope with surgery, should the unlikely happen, the baby is close to a centre of paediatric surgical excellence in case an emergency operation is needed. The hernia repair generally is not technically difficult - the anaesthetic is often more 'complicated' i.e. takes longer than the surgery. I cannot exactly answer your question about risk, because this depends so very much on the surgeon, the hospital and even the country where the surgery is to be done. I would assume that if the operation is planned to be very soon, it should be because the risk of obstruction is considered to be high... and I would recommend that you seek advice from a specialist paediatric surgeon as to the necessity to 'time' the operation so soon after birth. In any event I would recommend this operation be done at a large centre for paediatric surgery. Hope this helps: let me know if you have more questions. Good luck
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