Inguinal hernia repair in a community setting: implications for the elderly

Area of Science:

• Surgery
• Geriatrics
• Public Health

Background:

• Inguinal hernia repair is generally considered a low-risk surgical procedure.
• However, the safety and efficacy in elderly patients with significant comorbidities require specific investigation.

Purpose of the Study:

• To evaluate the outcomes of open inguinal hernia repair with mesh in elderly patients (≥65 years) compared to younger patients.
• To determine if advanced age and comorbidities increase the risk of postoperative complications or hernia recurrence.

Main Methods:

• A retrospective review of a prospectively collected database from a single surgeon over 9 years.
• Included 2,145 open inguinal hernia repairs (mesh) in 1,889 patients, with 81% performed under local anesthesia with sedation.
• Comorbidities and complications were compared between patients younger and older than 65.

Main Results:

• Older patients (499) were more likely to have comorbidities (74% vs. 39%) including hypertension, coronary artery disease, and benign prostatic hypertrophy.
• Postoperative complication rates (6% vs. 7%) and recurrence rates (2% vs. 3%) were not significantly different between older and younger patient groups.
• No deaths occurred, and common complications included recurrence, hematoma, and nerve entrapment in both age groups.

Conclusions:

• Open inguinal herniorrhaphy, particularly under local anesthesia, is a safe and highly successful procedure for the elderly population.
• Significant comorbidities do not appear to elevate the risk of complications or recurrence in older patients undergoing inguinal hernia repair.