Abstract
ObjectivesAlthough 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.MethodsThis retrospective study included all patients who had IH repair from 2010 to 2020. The primary outcomes of interest were postoperative complications and recurrence.ResultsA 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, p<0.001). The rate of complications was also higher for emergency surgery than for elective surgery (22.6% emergency versus 6.1% elective, p<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. ConclusionsIH 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.
Highlights
Inguinal hernia (IH) is a common disease among all age groups that requires surgery: 27%-42% of affected male and 3%-6% of affected female patients [1,2]
We recommend offering elective hernia repair to older patients to avoid the higher complication rate associated with emergency repair
IH has a high prevalence in the older population (≥65 years), which can be attributed to multiple factors, including abdominal wall weakness, benign prostatic hyperplasia, chronic cough, and chronic constipation, all of which are common in this age group [1,2,3,4]
Summary
Inguinal hernia (IH) is a common disease among all age groups that requires surgery: 27%-42% of affected male and 3%-6% of affected female patients [1,2]. Up to 8% of IH emergency surgery is indicated when incarceration, obstruction, or strangulation occurs as a result of a narrow hernia neck or adhesions between the hernia content and sac [7,9]. Most of those who have emergency surgery are older, and older patients have significantly higher morbidity and mortality rates than younger patients do [2,9]
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