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腹腔镜腹股沟疝修补术作为 80 岁及以上患者 24 小时日间手术的可行性和安全性:一项回顾性队列研究。

The feasibility and safety of laparoscopic inguinal hernia repair as a 24-h day surgery for patients aged 80 years and older: a retrospective cohort study.

机构信息

Vascular, Hernia and Abdominal Wall Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China.

The Second Clinical Medical College of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China.

出版信息

Hernia. 2023 Dec;27(6):1533-1541. doi: 10.1007/s10029-023-02912-x. Epub 2023 Oct 29.

DOI:10.1007/s10029-023-02912-x
PMID:37898974
Abstract

INTRODUCTION

As the proportion of aging adults increases and inguinal hernia repair becomes increasingly popular as a day surgery, the demand for laparoscopic inguinal hernia repair as a day surgery is increasing among patients aged 80 years and older. Relevant research needs to be completed, so we aimed to evaluate laparoscopic inguinal hernia repair as a 24-h day surgery for this group of patients.

METHODS

In this retrospective cohort study, we utilized propensity score matching to analyze the data of patients who underwent laparoscopic inguinal hernia repair at a day surgery center between January 1, 2019, and March 1, 2022. Patients were divided into ≥ 80 years old and < 80 years old groups. We compared the perioperative laboratory results, perioperative outcomes, and 1-year complications between the two groups.

RESULT

A total of 554 patients were included in the study. After propensity score matching, 292 patients were included in the matched cohort (98 patients in the ≥ 80 years old group and 194 patients in the < 80 years old group). During hospitalization, there were significant differences in ASA classification, Caprini score, length of hospital stays, risk of thrombosis, and delayed discharge rate. No significant difference was found in the incidence of total postoperative complications between the two groups at the 1-year follow-up (HR: 0.96, 95% CI 0.36-2.54, P = 0.96).

CONCLUSION

In our study, LIHR as a 24-h day surgery was safe and effective for patients over 80 years old. However, to reduce the rate of delayed discharge, cautious perioperative evaluation is necessary.

摘要

简介

随着老年人口比例的增加,以及腹股沟疝修补术作为日间手术越来越受欢迎,80 岁及以上患者对作为日间手术的腹腔镜腹股沟疝修补术的需求也在增加。需要完成相关研究,因此我们旨在评估腹腔镜腹股沟疝修补术作为这组患者的 24 小时日间手术。

方法

在这项回顾性队列研究中,我们利用倾向评分匹配分析了 2019 年 1 月 1 日至 2022 年 3 月 1 日期间在日间手术中心接受腹腔镜腹股沟疝修补术的患者的数据。患者分为≥80 岁和<80 岁两组。我们比较了两组患者的围手术期实验室结果、围手术期结局和 1 年并发症。

结果

共纳入 554 例患者。经过倾向评分匹配后,共有 292 例患者纳入匹配队列(≥80 岁组 98 例,<80 岁组 194 例)。住院期间,ASA 分级、Caprini 评分、住院时间、血栓风险和延迟出院率存在显著差异。两组患者在 1 年随访时的总术后并发症发生率无显著差异(HR:0.96,95%CI 0.36-2.54,P=0.96)。

结论

在我们的研究中,LIHR 作为 24 小时日间手术对 80 岁以上患者是安全有效的。然而,为了降低延迟出院率,需要谨慎进行围手术期评估。

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本文引用的文献

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Safety and Feasibility of Laparoscopic Transabdominal Preperitoneal Hernia Repair for Octo- and Nonagenarians.腹腔镜经腹腹膜前疝修补术治疗 80 岁及以上高龄患者的安全性和可行性。
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Predictors of long-term mortality in octogenarian veterans following inguinal hernia repair.
八旬老兵腹股沟疝修补术后长期死亡率的预测因素。
Hernia. 2022 Feb;26(1):243-249. doi: 10.1007/s10029-021-02525-2. Epub 2021 Oct 22.
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Effect of carbon dioxide pneumoperitoneum on acid-base balance during laparoscopic inguinal hernia repair: a prospective randomized controlled study.二氧化碳气腹对腹腔镜腹股沟疝修补术中酸碱平衡的影响:一项前瞻性随机对照研究。
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