Akeel Nouf
Department of Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.
Cureus. 2021 Sep 21;13(9):e18170. doi: 10.7759/cureus.18170. eCollection 2021 Sep.
Objectives Although inguinal hernia (IH) repair is low-risk surgery, older patients are occasionally offered watchful waiting because of their functional status and comorbidities. This study reviewed the surgical outcomes of IH repair in older patients in comparison with outcomes in younger patients. Methods This retrospective study included all patients who had IH repair from 2010 to 2020. The primary outcomes of interest were postoperative complications and recurrence. Results A total of 262 patients underwent IH repair during the study period; 40% were ≥60 years old. One patient had a recurrence. Among the 8% of patients who had postoperative complications, groin pain was the most common one (1.9%). Female patients had a significantly higher rate of complications than male patients did (38.5% female versus 6.4% male, <0.001). The rate of complications was also higher for emergency surgery than for elective surgery (22.6% emergency versus 6.1% elective, <0.001), as well for patients who needed concomitant bowel resection compared with those who did not. Patients who had emergency surgery or postoperative complications had a prolonged hospital stay. Conclusions IH repair in older patients is low-risk surgery, comparable to that in younger patients. In this study, emergency surgery was more common in older than in younger patients and posed a higher risk of complications. We recommend offering elective hernia repair to older patients to avoid the higher complication rate associated with emergency repair.
目的 尽管腹股沟疝（IH）修补术是低风险手术，但老年患者因其功能状态和合并症偶尔会选择观察等待。本研究比较了老年患者与年轻患者IH修补术的手术结果。方法 这项回顾性研究纳入了2010年至2020年期间所有接受IH修补术的患者。主要关注的结果是术后并发症和复发情况。结果 在研究期间，共有262例患者接受了IH修补术；40%的患者年龄≥60岁。1例患者复发。在有术后并发症的8%的患者中，腹股沟疼痛是最常见的（1.9%）。女性患者的并发症发生率明显高于男性患者（女性为38.5%，男性为6.4%，<0.001）。急诊手术的并发症发生率也高于择期手术（急诊为22.6%，择期为6.1%，<0.001），需要同时进行肠切除的患者与不需要的患者相比也是如此。接受急诊手术或有术后并发症的患者住院时间延长。结论 老年患者的IH修补术是低风险手术，与年轻患者相当。在本研究中，急诊手术在老年患者中比在年轻患者中更常见，且并发症风险更高。我们建议为老年患者提供择期疝修补术，以避免与急诊修补相关的更高并发症发生率。
