Department of Surgery, Abington Memorial Hospital, 1200 Old York Rd, Abington, PA 19001, USA.
Hernia. 2012 Aug;16(4):425-9. doi: 10.1007/s10029-012-0932-3. Epub 2012 Jun 16.
Assess the impact of age and type of hernia on the outcomes of laparoscopic ventral hernia repair (LVHR).
Operating room database of all laparoscopic ventral hernias performed from April 2001 to July 2010 was analyzed retrospectively. Patients were divided into two groups: primary hernias (Group 1) and incisional hernias (Group 2). These groups were further stratified into patients <65 years of age (Groups 1A and 2A) and patients >65 years of age (Groups 1B and 2B). Patient demographics, hernia characteristics, perioperative outcomes, and disposition at discharge were compared. p-values <0.05 were considered significant.
325 patients, with a mean age of 56.6 years (24-93 years) underwent LVHR. The mean length of stay (LOS) was longer (2.7 days vs 1.7 days, p value = 0.02), and the rate of same day discharge was also significantly lower (12 vs. 25 %, p = 0.02) for Group 2B when compared to Group 2A. Three patients in Group 2B, who had been living independently, were discharged to a skilled nursing facility, which proved significantly different when compared with Group 2A. There was no statistically significant difference in perioperative outcomes between younger and older subgroups with primary hernias.
LVHR in the elderly with incisional hernias have longer LOS and have a higher need for post-discharge nursing care unlike their counterparts with primary hernias. Identifying this cohort of patients early on helps the health-care providers to optimize the outcomes.
评估年龄和疝类型对腹腔镜腹疝修补术（LVHR）结果的影响。
回顾性分析 2001 年 4 月至 2010 年 7 月所有腹腔镜腹疝手术的手术室数据库。患者分为两组：原发性疝（第 1 组）和切口疝（第 2 组）。这两组进一步分为 <65 岁的患者（第 1A 组和第 2A 组）和 >65 岁的患者（第 1B 组和第 2B 组）。比较患者的人口统计学、疝特征、围手术期结果和出院时的处置。p 值 <0.05 被认为具有统计学意义。
325 例患者，平均年龄 56.6 岁（24-93 岁），行 LVHR。第 2B 组的平均住院时间（LOS）较长（2.7 天比 1.7 天，p 值=0.02），当天出院率也明显较低（12%比 25%，p=0.02）。第 2B 组中有 3 例生活自理的患者出院到疗养院，这与第 2A 组有显著差异。原发性疝的年轻和年长亚组之间在围手术期结果方面无统计学差异。
与原发性疝相比，老年切口疝患者行 LVHR 的 LOS 较长，出院后需要更多的护理。尽早识别这组患者有助于医疗保健提供者优化结果。
