Incarcerated inguinal hernias surgical treatment specifics in elderly patients.
2012
Background/Aim. Incarcerated inguinal hernias surgical treatment represents
one of the most frequent surgical treatments in elderly patients. The
percentage of incarcerated inguinal hernias urgent surgical treatments is
growing exponentially with the age in patients over 50. The aim of the study
was to investigate some of the factors that may have impact on the
incarcerated inguinal hernias surgical treatment outcome in elderly patients.
Methods. The study included 180 patients classified in two groups: the study
group (> 65 years of age) and the control group (≤ 65), managed in the
period from January 2005 till March 2009 at the General Surgery Clinic,
Clinical Center Nis. Results. Most of the patients had right inguinal hernia
(52.6%, the study group; 59.1%, the control group). All the study group
patients suffered from some of accompanying chronic diseases (100%), opposite
to 39 (59%) patients of the control group. Synthetic material was implanted
in 124 (68.9%) patients, while the tension technique was performed in 65
(31.1%) patients. The duration of incarceration more than 24 h (p = 0.015),
previous abdominal surgery (p = 0.001), the American Society of
Anesthesiologists physical status classification system (ASA classification)
(p = 0.033) and the presence of chronic diseases (p = 0.01) appeared to be
statistically significant risk factors for performing intestinal resection in
the study group, while in the control group they represented risk factors,
but not at the level of statistical significance (p <0.05), except for the
duration of incarceration (p = 0.007). A higher ASA stage (p = 0.001) and the
presence of bowel resection (p <0.001) are the most important risk factors
for lethal outcome in both groups of patients. Conclusion. Incarcerated
inguinal hernia in elderly patients is a serious problem. A higher ASA score
and the presence of bowel resection are the most important factors related to
unfavorable outcome.
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