The Effectiveness of Open Surgical Interventions for Inguinal Hernias in Elderly Patients

Abstract

Purpose. To evaluate the effectiveness of open methods of surgical treatment of inguinal hernia in elderly patients. Material and methods. The study includes 336 elderly patients with inguinal hernias. The Bassini hernioplasty was performed on 106 patients, the Liechtenstein technique was applied to 110 patients and the new tension-free method – to 120 patients. The effectiveness of hernioplasty was evaluated according to the results of the examination of patients in the early and remote postoperative periods, as well as the methodology for calculating the effectiveness of medical technologies in healthcare. Results. With open surgical interventions in patients with inguinal hernias in the early postoperative period there is an increase in the volume of the testicle on the side of surgery. In the remote period only after the Lichtenstein hernioplasty there was a decrease in the volume of the testicle (p<0.05). The relapse of the hernia (1-3 years later) after the Bassini hernioplasty took place in 9.4% cases, after the Liechtenstein hernioplasty - in 3.6% patients, and after applying the new method of hernioplasty there was no relapse of hernia. The new technique of tension-free hernioplastics was characterized by the highest level of medical (Km=1.00) and social efficiency (Ks=0.86). Conclusion. The new technique of open tension-free inguinal hernioplasty is characterized by the highest level of medical and social efficiency.

Impact of the type of anesthesia on the frequency of postoperative complications after hernioplasty and on the dynamics of the frailty index in elderly patients with inguinal hernia

“…For instance, Zhuk S. A., Smotrin S. M. (2023), evaluating the effectiveness of different methods of inguinal hernioplasty in elderly patients (336 patients with inguinal hernias aged 60 to 75 years), concluded that the most frequent postoperative complications were inflammatory infiltrate in the area of the postoperative wound, wound suppuration, mesh endoprosthesis rejection, hematoma in the area of surgery, testicular edema, and hernia recurrence, which differs from our results. At the same time, the authors analyzed several methods, including the Lichtenstein method (used by us), but did not study the effect of anesthesia or the dynamics of the FI, which, in our opinion, is some limitation of this study [14].…”