Characteristics of Inguinal Hernias in Patients Aged 80 Years or Older and Treatment Strategy

Abstract

The characteristics and treatment strategy of inguinal hernias in older patients were investigated. Methods : A total of 873 patients with inguinal hernia were divided into two group : 167 aged ≥ 80 years and 706 aged < 80 years. After excluding 3 of the older patients who underwent bowel resection, the remaining 164 were divided into 88 who underwent laparoscopic transabdominal preperitoneal (TAPP) repair and 76 who underwent open hernia repair, and their clinical characteristics and surgical outcomes were compared. Results : The older patient group included a high proportion of high-risk patients, with 42% being American Society of Anesthesiologists (ASA)-physical status ASA III, and 13% had incarcerated hernias. For older patients who underwent TAPP repair, the mean number of analgesic administrations was 0.4 ± 0.7 times, and the mean hospital stay was 3.0 ± 2.3 days, both significantly lower than the corresponding figures of 1.4 ± 1.2 times and 4.1 ± 4.1 days for those treated by open hernia repair. When the surgical indications for TAPP repair in older patients were set to include those of ASA III or less and expanded over time, the procedure could be performed safely with no serious complications. Conclusions : TAPP repair is a useful option for older patients with inguinal hernia who are ASA III or less and who are capable of tolerating general anesthesia.