Malik Arshad Mehmood, Khan Asad, Talpur Khamiso Altaf Hussain, Laghari Abdul Aziz
Department of Surgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan.
J Pak Med Assoc. 2010 Jan;60(1):45-7.
To study various factors influencing outcome of open hernia repair in elderly population.
This is a retrospective descriptive study from January 2004 to December 2008 including all patients (n = 212) of 60 years and above operated for inguinal hernias either electively or in emergency during this period. One of the co-authors was assigned the duty to collect the record files of all patients over 60 years age operated for inguinal hernia in the department of surgery LUMHS as well as in private hospitals in Hyderabad. The records of all patients were reviewed and data retrieved on a proforma mentioning variables to investigate the common co-morbidities and their influence on the overall results of surgical intervention in geriatric patients. SPSS version 12 was used for statistical analysis of the data.
The mean age of the patients in this series was 69.82 +/- 7.8 years of whom 208 (98%) were males and 4 (2%) females. In 190 (89.61%) patients the hernias were unilateral while 12 (5.7%) cases had bilateral inguinal hernias and 10 (4.7%) patients presented with recurrent hernias. In 159 (75%) patients the hernia was simple while 53 (25%) patients presented with one or the other complication such as obstruction or strangulation. Elective surgery was performed in 161 (75.9%) patients while 51 (24.1%) patients were operated in emergency. Co-morbidities were present in 79 (37.26%) patients. Out of the total study population, 7 (3.30%) patients died of which 6 were operated in emergency and had co-morbidities. All of them had gangrene of bowel for which resection and anastomosis was done. One patient died of acute MI on 5th post-operative day.
Emergency hernia surgery carries a high mortality in elderly patients. Co-existing medical problems make surgery still challenging in the geriatric population. An early elective hernia repair is highly recommended.
研究影响老年人群开放性疝修补术预后的各种因素。
这是一项回顾性描述性研究，时间跨度为2004年1月至2008年12月，纳入了在此期间因腹股沟疝接受择期或急诊手术的所有60岁及以上患者（n = 212）。其中一位共同作者负责收集在拉合尔大学医学与健康科学学院外科以及海得拉巴私立医院接受腹股沟疝手术的所有60岁以上患者的病历档案。对所有患者的记录进行了回顾，并根据一份提及变量的表格检索数据，以调查常见的合并症及其对老年患者手术干预总体结果的影响。使用SPSS 12版对数据进行统计分析。
该系列患者的平均年龄为69.82±7.8岁，其中208例（98%）为男性，4例（2%）为女性。190例（89.61%）患者的疝为单侧，12例（5.7%）为双侧腹股沟疝，10例（4.7%）为复发性疝。159例（75%）患者为单纯疝，53例（25%）患者伴有诸如梗阻或绞窄等一种或多种并发症。161例（75.9%）患者接受了择期手术，51例（24.1%）患者接受了急诊手术。79例（37.26%）患者存在合并症。在整个研究人群中，7例（3.30%）患者死亡，其中6例接受了急诊手术且有合并症。他们均发生了肠坏疽，为此进行了切除和吻合术。1例患者在术后第5天死于急性心肌梗死。
老年患者急诊疝手术的死亡率很高。并存的医疗问题使老年人群的手术仍然具有挑战性。强烈建议尽早进行择期疝修补术。
