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Ulus Travma Acil Cer · Mar 2017
Approach to inguinal hernia in high-risk geriatric patients: Should it be elective or emergent?
- Rıza Gürhan Işıl, Pınar Yazıcı, Uygar Demir, Cemal Kaya, Özgür Bostancı, Ufuk Oğuz İdiz, Canan Tülay Işıl, Mahmut Kaan Demircioğlu, and Mehmet Mihmanlı.
- Department of General Surgery, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul-Turkey. gurhanisil@hotmail.com.
- Ulus Travma Acil Cer. 2017 Mar 1; 23 (2): 122-127.
BackgroundElderly patients are more prone to have inguinal hernia due to weakened abdominal musculature. However, surgical repair of inguinal hernia (SRIH) may not be performed or may be delayed due to greater risk in presence of comorbidities. Present study is investigation of outcome of elective and emergency SRIH in geriatric patients.MethodsRecords of total of 384 high-risk (American Society of Anesthesiology classification III-IV) patients aged >65 years who underwent SRIH between January 2010 and December 2014 were reviewed. Patients were divided into 2 groups according to procedure type: elective (Group EL) or emergency (Group EM). Demographic features and surgical and postoperative period data of 2 groups were recorded and compared.ResultsDemographic data were similar, but number of ASA IV patients was greater in Group EM. Frequency of intestinal resection was significantly greater in emergency surgery group (1% vs 21%; p<0.01). Length of hospital stay (1.3 days vs 7.9 days; p<0.01) and intensive care unit stay (0.17 days vs 4.04 days; p<0.01) were also greater in Group EM. Morbidity (1% vs 24%; p<0.01) and mortality (0.3% vs 11%; p<0.01) were also significantly higher in Group EM compared to elective SRIH group.ConclusionEmergency inguinal hernia surgery is associated with significantly higher morbidity and mortality compared with elective SRIH in high-risk geriatric patients. Elective hernia repair in these patients should be considered to reduce risk of need for intestinal resection as well as length of hospital stay.
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