Inguinal hernia repair in a community setting: implications for the elderly

Rogers, Frederick B.; Guzman, Eduardo A.

doi:10.1007/s10029-010-0733-5

Cited by 16 publications

(13 citation statements)

References 11 publications

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“…In contrast to other authors [ 10 - 13 ], major complications were 14.24% (6/42: 2 chronic inguinal pain, 4 recurrences). Minor complications were 5/42 (11.90%) and included only asymptomatic seromas that were aspirated.…”

Section: Methodscontrasting

confidence: 87%

Wound defects in the elderly: our experience

2011

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Section: Methodscontrasting

confidence: 87%

Wound defects in the elderly: our experience

2011

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“…When elderly patients present with complications such as incarceration or strangulation, their morbidity and mortality is much higher (). As such, it would be beneficial if inguinal hernia repairs could be performed in the elderly on an elective basis (). Laparoscopic inguinal hernia repair requires general anesthesia, whereas the open technique can be carried out with local, regional, or general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…However, recent outcome studies have shown that, compared with the use of regional anesthesia, the use of general anesthesia carries with it no increase in morbidity or mortality in elderly patients (). For extremely sick patients with severe comorbidities and high operative risk, inguinal herniorrhaphy under local anesthesia should be considered (). This appropriate selection of patients and operative and anesthetic procedures could reduce the rate of severe complications that potentially lead to mortality in elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Single‐incision totally extraperitoneal inguinal hernia repair is safe and feasible in elderly patients: A single‐center experience of 365 procedures

Wakasugi

Tei

Anno

et al. 2016

Asian J Endoscop Surgery

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The aim of this study was to evaluate the feasibility and safety of SILS for totally extraperitoneal inguinal hernia repair in elderly patients. A retrospective analysis of 365 patients who underwent of SILS for totally extraperitoneal inguinal hernia repair from January 2012 to November 2015 at Osaka Police Hospital was performed, and the outcomes of patients aged <80 years and those aged ≥80 years were compared. There was a greater proportion of patients with an ASA score ≥3 among those ≥80 years than among those <80 years. The mean operative time for unilateral inguinal hernia was 94 min in patients <80 years and 98 min in patients ≥80 years. The mean operative time for bilateral inguinal hernia was 133 min in patients <80 years and 130 min in patients ≥80. Intraoperative bleeding was minimal in all patients. Conversion to a different operative procedure occurred in 3% (10/322) of patients <80 years and in 5% (2/43) of patients ≥80 years (P = 0.6). The mean postoperative hospital stay was 2.2 days for patients <80 years and 2.2 days for patients ≥80 years. The mean follow-up period 21 ± 14 months (range, 3-50 months) for patients <80 years and 17 ± 14 months (range, 3-50 months) for patients ≥80 years (P = 0.3). Postoperative complications were seen in 12% (38/322) of patients <80 years and in 14% (6/43) of patients ≥80 years (P = 0.7). A seroma was seen in 9% (28/322) of patients <80 years and in 12% (5/43) of patients ≥80 years (P = 0.6). A wound infection occurred in 2% (8/322) of patients <80 years. These seromas and wound infections were managed conservatively. Pulmonary embolism was seen in one patient <80 years (0.3%). There was no mortality or recurrence in either group. SILS for totally extraperitoneal inguinal hernia repair has good cosmesis and can be performed in elderly patients with acceptable morbidity and mortality.

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“…It is important to recognize that incarcerated and strangulated hernias have more serious implications in the elderly, thus supporting early elective repair in this population. However, elective repair of inguinal hernias in the elderly are more often deferred because of a perception of increased operative risk 1 …”

Section: Introductionmentioning

confidence: 99%

“…However, elective repair of inguinal hernias in the elderly are more often deferred because of a perception of increased operative risk. 1 Two methods exist for inguinal hernia repair: the open approach and the laparoscopic approach. The laparoscopic approach was introduced in the early 1990s.…”

Section: Introductionmentioning

confidence: 99%