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老年患者腹腔镜与开放式腹股沟疝修补术的手术和生活质量结局评估。

Assessment of Surgical and Quality-of-Life Outcomes Between Laparoscopic Versus Open Inguinal Hernia Repair in Geriatric Patients.

机构信息

Department of General Surgery, Cekirge State Hospital, Bursa, Turkey.

Department of General Surgery, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey.

出版信息

J Laparoendosc Adv Surg Tech A. 2023 Sep;33(9):872-878. doi: 10.1089/lap.2023.0147. Epub 2023 Jun 20.

Abstract

Inguinal hernia repair is a common surgery, especially in the elderly population. However, the decision to perform surgery in elderly patients can be challenging due to higher complication rates. Laparoscopic inguinal hernia surgery is less commonly used in the elderly population despite its advantages. In this study, we aimed to investigate the safety and advantages of laparoscopic inguinal hernia surgery in elderly patients. We retrospectively compared the preoperative and postoperative (PO) data and Short Form-36 (SF-36) forms of elderly patients who underwent laparoscopic transabdominal preperitoneal and open inguinal hernia surgery. The primary outcomes were PO pain scores and complication rates. A total of 79 patients with an age range between 65 and 86 years, who presented with inguinal hernias to Cekirge State Hospital's General Surgery Department between January 2017 and November 2019, were included. Seventy-nine patients underwent laparoscopic transabdominal preperitoneal technique and Lichtenstein hernia repair. The laparoscopic group had a lower rate of PO complications and less analgesic medication consumption and usage time compared with the open group. Furthermore, compared with the open group, the laparoscopic group had lower PO pain scores and higher SF-36 scores for physical function, physical role, pain, and general health at the 30th and 90th days after surgery. Our study suggests that laparoscopic inguinal hernia surgery can be safely performed in elderly patients with lower complication rates and faster recovery times compared with open surgery. The advantages of laparoscopic surgery, such as lower PO pain scores and faster recovery times, were also observed in elderly patients.

摘要

腹股沟疝修补术是一种常见的手术,尤其在老年人群中更为常见。然而,由于老年患者的并发症发生率较高,因此在老年患者中决定是否进行手术具有挑战性。尽管腹腔镜腹股沟疝手术具有优势,但在老年人群中使用较少。本研究旨在探讨腹腔镜腹股沟疝手术在老年患者中的安全性和优势。我们回顾性比较了在 Cekirge 州立医院普外科接受腹腔镜经腹腹膜前和开放式腹股沟疝手术的老年患者的术前和术后(PO)数据和 Short Form-36(SF-36)表格。主要结果是 PO 疼痛评分和并发症发生率。共纳入 2017 年 1 月至 2019 年 11 月期间因腹股沟疝就诊于 Cekirge 州立医院普外科的年龄在 65 至 86 岁之间的 79 例患者。79 例患者接受了腹腔镜经腹腹膜前技术和 Lichtenstein 疝修补术。与开放组相比,腹腔镜组术后 PO 并发症发生率较低,镇痛药使用量和使用时间较少。此外,与开放组相比,腹腔镜组在术后第 30 天和第 90 天的 PO 疼痛评分较低,身体功能、身体角色、疼痛和一般健康的 SF-36 评分较高。我们的研究表明,与开放式手术相比,腹腔镜腹股沟疝手术可在老年患者中安全进行,并发症发生率较低,恢复时间更快。腹腔镜手术的优势,如 PO 疼痛评分较低和恢复时间较快,在老年患者中也得到了观察。

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