Laparoscopic versus Open Inguinal Hernia Repair in Aging Patients: A Propensity Score Matching-Based Retrospective Study

Abstract

Objective Although laparoscopic repair has been widely carried out and promoted due to its minimally invasive advantages, open surgery is still popular compared to elderly patients. This study aims to compare the outcomes of laparoscopic (LIHR) vs open repair of inguinal hernias (OIHR) in elderly patients. Methods A retrospective analysis of the database was performed to identify elderly patients, from January 2021 through December 2022, who underwent surgery for an inguinal hernia. After a 1:1 propensity score matching (PSM) with a caliper of 0.1 was conducted to balance potential bias, binary logistic regressions were used for categorical and continuous outcomes. Results After PSM, 78 pairs of elderly patients were enrolled in this study, and there were no significant differences in baseline between LIHR and OIHR groups. Compared to OIHR, univariable and multivariable logistic regression analysis showed that LIHR was independently affected for reducing intraoperative hemorrhage (OR = 0.06, 95% CI: 0.02–0.18, P < 0.001) and shortening postoperative hospitalization time (OR = 0.29, 95% CI: 0.15–0.57, P < 0.001) in elderly patients. Furthermore, LIHR (OR = 0.28, 95% CI: 0.14–0.57, P < 0.001) and age (OR = 0.89, 95% CI: 0.82–0.96, P = 0.002) were independent affecting factors for relieving postoperative pain. Meanwhile, no obvious differences were detected in postoperative complications [LIHR 7.7% (6/78) vs OIHR 14.1% (11/78), P = 0.199]. Conclusion LIHR was closely associated with reducing intraoperative hemorrhage and shortening postoperative hospitalization time. Whilst LIHR and age were independently affecting factors for relieving postoperative pain.

Single-incision laparoscopic surgery transabdominal preperitoneal approach for hernia in elderly: a cross-sectional study

“…[8,9] Also, laparoscopic surgery offers a similar operation time, complications, mortality, and recurrence rate as open surgeries. [10][11][12] Thus, laparoscopic surgery, including transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) surgery, has been considered a safe and feasible way to treat IH in the elderly.…”