Inguinal and femoral hernia repair in geriatric patients

In a five year period, 62 patients aged 70 to 91 years underwent operative inguinal hernial repair. Other significant ailments were present in 46 of the 51 men and six of the 11 women. Postoperatively, complications occurred in 16 patients, four of whom died. In 44 patients with reducible hernia undergoing elective repair, there were no deaths and complications occurred in eight, while, in contrast, of the 18 with incarcerated or strangulated hernia, complications occurred in ten, and four died. The differences statistically significant. Local anesthesia was associated with the lowest complication rate. All cardiovascular complications and all deaths occurred in those receiving either general or spinal anesthesia. Inguinal herniorrhaphy can be safely performed in geriatric patients. Because of high morbidity and mortality associated with incarceration, elective repair of inguinal hernia under local anesthesia should be done whenever possible.