Minimally invasive treatment and surgical injury control strategies for elderly patients with acute incarcerated ingui-nal hernias
10.3969/j.issn.1009-9905.2024.08.007
- VernacularTitle:老年急性嵌顿性腹股沟疝的微创治疗及手术损伤控制策略
- Author:
Zhou-Wei XU
1
;
Bai-Cheng DING
;
Kai-Qiang WANG
;
Tian-Le ZHAO
;
Xing-Han LI
;
Xing-Yu WANG
Author Information
1. 安徽医科大学第一附属医院 急诊外科(安徽 合肥 230022)
- Keywords:
Hernia,inguen,incarcerated,acute;
Elderly;
Hernioplasty,laparoscope;
injury control
- From:
Chinese Journal of Current Advances in General Surgery
2024;27(8):622-626
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application value and damage control of minimally inva-sive techniques in the treatment of acute incarcerated inguinal hernias in the elderly.Methods:In this study,62 elderly patients with acute incarcerated inguinal hernias admitted to the department of emergency surgery at the First Affiliated Hospital of Anhui Medical University from June 2018 to June 2023 were selected as the research subjects.After obtaining informed consent from the pa-tient's family for both treatment modalities,they were randomly divided into open surgery group and laparoscopic surgery group.Differences in clinical efficacy,perioperative indicators,post-operative complications,and prognostic follow-up of the two groups of patients were observed.Seven cases of elderly patients aged above 80 had many underlying diseases and poor tolerance during surgery.After treatment of lesions in the hernia contents,only damage control surgery for hernia sac high ligation was performed.Results:In comparison to patients treated with laparo-scopic surgery,there were statistically significant differences(P＜0.05)in the open surgery group in clinical efficacy(efficacy,ineffectiveness,and overall effectiveness),perioperative indicators(length of stay,recovery time of digestive tract function,and VAS pain score),post-operative complica-tions,and prognostic follow-up(local mass,chronic pain,and ratio of second-stage hernia sur-gery).Seven patients treated according to injury control strategies all recovered and discharged from hospital after surgery.Conclusion:Emergency laparoscopic surgery for detecting incarcer-ated inguinal hernias in the elderly is safe and feasible.At the same time,it is essential to correctly assess the patient's vital signs during surgery.If necessary,surgery should be simplified to provide opportunities for follow-up treatment.
