Surgical approach and efficacy analysis for inguinal hernia in patients 85 years old or above
10.3760/cma.j.cn113855-20250724-00371
- VernacularTitle:85岁及以上患者腹股沟疝手术方式选择及疗效分析
- Author:
Ruidong YU
1
;
Rongduo YANG
;
Shaochun LI
;
Zhixiong WU
;
Yunxiao MENG
;
Jianxiong TANG
;
Yan GU
;
Shaojie LI
Author Information
1. 复旦大学附属华东医院重症医学科，上海 200040
- Publication Type:Journal Article
- Keywords:
Hernia,inguinal;
Aged;
Surgical approach;
Anesthesia
- From:
Chinese Journal of General Surgery
2025;40(9):686-690
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and surgical seletion or timing for elderly patients(≥85 years) with inguinal hernia.Methods:A retrospective analysis was conducted on clinical data of 323 patients aged ≥ 85 years who underwent surgical treatment for inguinal hernia admitted to the Department of General Surgery of East China Hospital Affiliated to Fudan University from Jan 2020 to Dec 2024.There were 308 males (95.36%) and 15 females (4.64%), with an average age of (87.83 ± 1.91) years. The ASA classification included 15 cases of grade Ⅰ, 209 cases of grade Ⅱ, 97 cases of grade Ⅲ, and 2 cases of grade Ⅳ.Results:Among the 323 patients, there were 20 bilateral hernia cases and 303 unilateral cases. Ninety-seven cases were of scrotal hernia. Surgical methods included 11 TAPP cases, 10 TEP cases, 297 Lichtenstein cases, 3 open suture repair and 2 laparoscopic suture repair. Four cases underwent intestinal resection and in two cases enterostomy was performed. The median follow-up after surgery was 3 months. Hernia recurrence was found in 2 cases, seroma in 14 cases, chronic pain in 2 cases, SSI in 11 cases, intestinal obstruction in 1 case, urinary retention in 3 cases, pulmonary infection in 9 cases, urinary tract infection in 2 cases, cardiovascular and cerebrovascular accidents in 2 cases. The incidence of postoperative complications in the emergency group was significantly higher than that in the elective group. Three deaths occurred within 30 days after surgery, all of which were in the emergency group.Conclusions:Selective inguinal hernia repair is safe and effective for over 85 year old patients with inguinal hernia. The incidence of emergency surgical complications and mortality is significantly increased. Lichtenstein surgery under local anesthesia or regional block anesthesia is the preferred method.
