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ISSN 1405-0099 (Print)

2018, Number 4

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Cir Gen 2018; 40 (4)

Clinical-epidemiological description of the patients older than 60 years operated on inguinal hernia

Alonso GT

Language: Spanish
References: 22
Page: 255-261
PDF size: 194.74 Kb.


ABSTRACT

Introduction: Inguinal hernia surgery in eldelry is one of the most common surgical pathologies, it has proven to be a safe surgery with low complication rate when performed electively. The objective of this work is to make a clinical-epidemiological description of patients operated on inguinal hernia and to determine which patients are most vulnerable to complications. Material and methods: Retrospective study. inguinal hernioplasty are analyzed over a one-year period of patients older than 60 years, taking as variables; age, sex, smoking, coexisting diseases, geriatric and American Society of Anesthesiologists evaluation, date of intervention, type of admission, surgery and anesthesia, classification of the hernia, surgical technique employed, placement of prosthetic material and complications. Results: Were analyzed 62 inguinal hernioplasty. 92% (57) presented at least two major comorbidities; hypertension (74.19%), diabetes mellitus (22.58%), chronic obstructive pulmonary diseases (16.12%), hypertensive, ischemic heart disease, auriculoventricuales blockades and ventricular fibrillations (17.74%), hypothyroidism (14.51%), 8% (5 cases) no diseases were associated. Complications of 9.68%: intraoperative arrhythmia, intraoperative simple diabetic decompensation and acute coronary syndrome, a scrotal hematoma and two inguinodinias. Conclusions: Age should not be a contraindication to performing an inguinal hernioplasty. The use of open and tension-free techniques in elderly are safe procedures, with a low percentage of complications and recurrences.


REFERENCES

  1. Amato B, Compagna R, Della Corte GA, Martino G, Bianco T, Coretti G, et al. Feasibility of inguinal hernioplasty under local anaesthesia in elderly patients. BMC Surg. 2012; 12 Suppl 1: S2.

  2. Amato B, Compagna R, Fappiano F, Rossi R, Bianco T, Danzi M, et al. Day-surgery inguinal hernia repair in the elderly: single centre experience. BMC Surg. 2013; 13 Suppl 2: S28.

  3. Nilsson H, Stylianidis G, Haapamäki M, Nilsson E, Nordin P. Mortality after groin hernia surgery. Ann Surg. 2007; 245: 656-660.

  4. Pol-Herrera PG, López-Rodríguez PR, León-González O, Caiñas-Román J, Cruz-García N, Pando-Santos A, et al. Cirugía de la hernia inguinal en la tercera edad: ambulatoria y con hospitalización corta. Rev Cubana Cir. 2011; 50: 73-81.

  5. Nienhuijs SW, Remijn EE, Rosman C. Hernia repair in elderly patients under local anaesthesia is feasible. Hernia. 2005; 9: 218-222.

  6. Hwang MJ, Bhangu A, Webster CE, Bowley DM, Gannon MX, Karandikar SS. Unintended consequences of policy change to watchful waiting for asymptomatic inguinal hernias. Ann R Coll Surg Engl. 2014; 96: 343-347.

  7. Fitzgibbons R, Forse RA. Groin hernias in adults. N Engl Med. 2015; 372: 756-763.

  8. Ponka JL, Brush BE. Experiences with the repair of groin hernia in 200 patients aged 70 or older. J Am Geriatr Soc. 1974; 22: 18-24.

  9. Azari Y, Perry Z, Kirshtein B. Strangulated groin hernia in octogenarians. Hernia. 2015; 19: 443-447.

  10. Csendes JA, Lembach JH, Molina FJC, Inostroza LG, Köbrich SS. Cirugía en mayores de 80 años: Evolución clínica y costos asociados. Rev Chil Cir. 2010; 62: 564-569.

  11. Mattila K, Vironen J, Eklund A, Kontinen VK, Hynynen M. Randomized clinical trial comparing ambulatory and inpatient care after inguinal hernia repair in patients aged 65 years or older. Am J Surg. 2011; 201: 179-185.

  12. Silverstein P. Smoking and wound healing. Am J Med. 1992; 15: 22S-24S.

  13. Lindström D, Sadr Azodi O, Bellocco R, Wladis A, Linder S, Adami J. The effect of tobacco consumption and body mass index on complications and hospital stay after inguinal hernia surgery. Hernia. 2007; 11: 117-123.

  14. Kulah B, Duzgun AP, Moran M, Kulacoglu IH, Ozmen MM, Coskun F. Emergency hernia repairs in elderly patients. Am J Surg. 2001; 182: 455-459.

  15. Rühling V, Gunnarsson U, Dahlstrand U, Sandblom G. Wound healing following open groin hernia surgery: the impact of comorbidity. World J Surg. 2015; 39: 2392-2399.

  16. Rogers FB, Guzman EA. Inguinal hernia repair in a community setting: implications for the elderly. Hernia. 2011; 15: 37-42.

  17. Compagna R, Rossi R, Fappiano F, Bianco T, Accurso A, Danzi M, et al. Emergency groin hernia repair: implications in elderly. BMC Surg. 2013; 13 Suppl 2: S29.

  18. Lundström KJ, Sandblom G, Smedberg S, Nordin P. Risk factors for complications in groin hernia surgery: a national register study. Ann Surg. 2012; 255: 784-788.

  19. Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO, Dunlop DD, Reda DJ, McCarthy M Jr, et al. Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA. 2006; 295: 285-292.

  20. Bay-Nielsen M, Kehlet H. Anaesthesia and post-operative morbidity after elective groin hernia repair: a nation-wide study. Acta Anaesthesiol Scand. 2008; 52: 169-174.

  21. Mayagoitia JC, Prieto-Díaz Chávez E, Suárez D, Cisneros HA, Tene CE. Predictive factors comparison of complications and recurrences in three tension-free herniorraphy techniques. Hernia. 2006; 10: 147-151.

  22. Paajanen H, Scheinin T, Vironen J. Análisis de las complicaciones relacionadas con la cirugía de la hernia inguinal. Am J Surg. 2010; 199: 746-751.




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