Fifty-three-year experience with pediatric umbilical hernia repairs. 
The aim of this study was to evaluate the long-term surgical and patient-reported outcomes of pediatric umbilical hernia (UH) repairs.  A retrospective review of all children (<18 years old) who underwent UH repair at Mayo Clinic-Rochester in the last half century was done.  Follow-up was obtained by mailed survey.  From 1956 to 2009, 489 children (boys, 251; girls, 238) underwent a primary UH repair.  The mean age was 3.9 years (range, 0.01-17.8 years).  Complicated UHs that required emergent repair (n = 34, or 7%) included recurrent incarceration (22), enteric fistula (7), strangulation (4), and evisceration (1).  Mean UH size was 1.3 cm (range, 0.2-7.0 cm), varying by operative indication (1.0 cm emergent vs 1.5 cm elective repairs, P = .008) and decade of repair (2.2 cm, 1950s-60s vs 1.3 cm, 1990s-2000s; P = .001).  Postoperative morbidity (2%) consisted of superficial wound infection (7), hematoma (3), and seroma (1).  With a 66% survey response rate and mean follow-up of 13.0 years (range, 0-53.8 years), 8 (2%) patients experienced a recurrence.  Most patients reported satisfaction (90%) with the cosmetic appearance of their umbilicus and are pain free (96%).  Pediatric UH repairs have low morbidity and recurrence rates.  Most patients are satisfied and pain free.  Importantly, complicated UHs were more likely to be associated with smaller defects; therefore, parental counseling for signs of incarceration is recommended even in small defects.