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About SickKids

November 3, 2008

Researchers determine that longer surgical wait times negatively affect infants with inguinal hernias

Longer wait times for infant inguinal hernia surgery is associated with more Emergency Department visits and higher complication rates, according to a team of researchers at The Hospital for Sick Children (SickKids). This research is reported in the November 3 issue of the Canadian Medical Association Journal (CMAJ).

Inguinal hernias are found in the groin area and are very common in infants under two years of age. Although prolonged wait times for hernia surgery have not been associated with adverse outcomes in adults, the effect in children has not been well researched. This study documents current wait times for inguinal hernia repair in infants less than two years of age in Ontario, and examines the relationship between wait times and outcome in these patients.

The study reveals the longer an infant waited for surgery, the more Emergency Department visits they made, an important indicator of parental concern and patient suffering as well as health system resource utilization.

Researchers found that if wait times are limited to 14 days, the risk for complication is almost 50 per cent less than if the infant waits the typical surgical wait time of 35 days, especially for infants under a year old.

“This study shows us that longer wait times can negatively affect children with this diagnosis, as well as their parents,” says Dr. Jacob Langer, Head of General Surgery, project investigator at SickKids Research Institute, professor in the Department of Surgery, at the University of Toronto , and the study's lead investigator. “We recommend that all infant inguinal hernias should be repaired within 14 days of surgical consultation.”

This study provides important information for the government's focus on wait time management. Shortening wait times for children in need of hernia repair is supported by this research.

Other members of this research team included: Dr. Mohammed Zamakhshary, a fellow in the Division of General Surgery; Dr. Teresa To, Head and Senior Scientist in the Child Health Evaluative Sciences Program at SickKids Research Institute and assistant professor in the Departments of Public Health Sciences, Health Policy, Management & Evaluation and Paediatrics & Institute for Medical Sciences at the University of Toronto; and Dr. Jun Guan from the Institute for Clinical Evaluative Sciences.