Laparoscopic ventral hernia repair in the elderly: does the type of hernia matter?
OBJECTIVE
Assess the impact of age and type of hernia on the outcomes of laparoscopic ventral hernia repair (LVHR).


METHODS
Operating room database of all laparoscopic ventral hernias performed from April 2001 to July 2010 was analyzed retrospectively. Patients were divided into two groups: primary hernias (Group 1) and incisional hernias (Group 2). These groups were further stratified into patients <65 years of age (Groups 1A and 2A) and patients >65 years of age (Groups 1B and 2B). Patient demographics, hernia characteristics, perioperative outcomes, and disposition at discharge were compared. p-values <0.05 were considered significant.


RESULTS
325 patients, with a mean age of 56.6 years (24-93 years) underwent LVHR. The mean length of stay (LOS) was longer (2.7 days vs 1.7 days, p value = 0.02), and the rate of same day discharge was also significantly lower (12 vs. 25 %, p = 0.02) for Group 2B when compared to Group 2A. Three patients in Group 2B, who had been living independently, were discharged to a skilled nursing facility, which proved significantly different when compared with Group 2A. There was no statistically significant difference in perioperative outcomes between younger and older subgroups with primary hernias.


CONCLUSIONS
LVHR in the elderly with incisional hernias have longer LOS and have a higher need for post-discharge nursing care unlike their counterparts with primary hernias. Identifying this cohort of patients early on helps the health-care providers to optimize the outcomes.
Department of Surgery, Abington Memorial Hospital, 1200 Old York Rd, Abington, PA 19001, USA. hpolavarapu@amh.org
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Polavarapu
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Kurian
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Josloff
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult