Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, National University Health System, Singapore, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
ANZ J Surg. 2022 Oct;92(10):2457-2463. doi: 10.1111/ans.18032. Epub 2022 Sep 8.
Groin hernia repair is a common surgical procedure and includes both open and laparoscopic techniques. Studies comparing outcomes of laparoscopic versus open groin hernia repair specifically in the geriatric population are lacking. This study compares the outcomes of laparoscopic versus open groin hernia repair techniques in older adults.
A literature search was conducted in each of the five selected databases up till June 2021: PubMed (MEDLINE), EMBASE, CINAHL, Cochrane and PsychInfo (OVID). Outcomes measured included but were not limited to total length of hospital stay, mean total operative time, intraoperative complications, post-operative complications such as wound infection, seroma formation, chronic pain, mesh infection and recurrence of inguinal hernia.
A total of five articles were included in the final analysis. The length of postoperative hospitalization stay was shorter in patients who underwent laparoscopic hernia repair (95% CI: -1.50 to -0.72; P < 0.01, I = 79%). The laparoscopic repair group had a significantly smaller number of patients who sustained postoperative wound infections (95% CI: 0.02 to 0.47; P = 0.003, I = 0%), and lower incidence of chronic pain (95% CI: 0.14 to 0.37, P < 0.01, I = 46%). Analysis of the remaining outcomes did not reveal any statistically significant differences between open and laparoscopic hernia repair.
The results of this analysis showed a shorter length of stay, lower wound infection rates and lower chronic pain with laparoscopic groin hernia repair as compared to open repair in older adults. Future prospective studies examining the impact of age on the relationship between surgical approach (open versus laparoscopic) and surgical outcomes are needed.
腹股沟疝修补术是一种常见的外科手术，包括开放手术和腹腔镜手术。缺乏专门针对老年人群体的腹腔镜与开放腹股沟疝修补术结果比较的研究。本研究比较了腹腔镜与开放腹股沟疝修补术在老年人中的结果。
在截止 2021 年 6 月的五个选定数据库中进行了文献检索：PubMed（MEDLINE）、EMBASE、CINAHL、Cochrane 和 PsychInfo（OVID）。测量的结果包括但不限于总住院时间、平均总手术时间、术中并发症、术后并发症（如伤口感染、血清肿形成、慢性疼痛、网片感染和腹股沟疝复发）。
共有五篇文章被纳入最终分析。腹腔镜疝修补组患者的术后住院时间更短（95%CI：-1.50 至-0.72；P<0.01，I²=79%）。腹腔镜修复组术后发生伤口感染的患者数量明显较少（95%CI：0.02 至 0.47；P=0.003，I²=0%），慢性疼痛的发生率也较低（95%CI：0.14 至 0.37，P<0.01，I²=46%）。对其余结果的分析并未发现开放和腹腔镜疝修补术之间存在任何统计学上显著差异。
与开放修复相比，腹腔镜腹股沟疝修补术在老年人中具有较短的住院时间、较低的伤口感染率和较低的慢性疼痛发生率。需要进一步的前瞻性研究来检查年龄对手术方法（开放与腹腔镜）与手术结果之间关系的影响。
