title: Comparing laparoscopic and open inguinal hernia repair in octogenarians.
abstract: OBJECTIVE
  To compare outcomes of laparoscopic and open inguinal hernia repair in elderly patients.
  
  
  METHODS
  We retrospectively reviewed patients ≥80 years old undergoing laparoscopic or open inguinal hernia repair from October 2006 to July 2009 at our medical center. Descriptive statistics were calculated, and outcomes were compared using Fisher's exact test, Wilcoxon rank-sum test, and Student's t test; a p value <0.05 was considered significant.
  
  
  RESULTS
  Open inguinal hernia repairs were performed in 58 patients, and laparoscopic repairs in 23 patients. There was no significant difference in average age (81 vs. 83 years, p = 0.09) or gender (91 % male vs. 74 % male, p = 0.1) for the laparoscopic versus open groups. Resident involvement (55 vs. 26 %, p = 0.02) was more common in the open group, and there was no difference in number of cases done for incarcerated hernias (17 vs. 13 %, p = 0.8) in the open versus laparoscopic groups. We observed a significant difference in hernia laterality and anesthesia type, with significantly more bilateral hernias (48 vs. 2 %, p ≤ 0.001) and more general anesthesia (100 vs. 31 %, p ≤ 0.001) in the laparoscopic compared with the open group. There were no significant differences in ASA score (p = 0.1), operating-room time (p = 0.6), urine output (p = 0.1), morbidity (p = 1), or mortality unrelated to the hernia surgery (13 vs. 22 %, p = 0.5) between the laparoscopic and open groups. At an average follow-up of 31 months (laparoscopic) and 19 months (open), only one recurrence occurred (open group).
  
  
  CONCLUSIONS
  Despite subtle differences between the laparoscopic and open approaches to inguinal hernia repairs in octogenarians, both procedures are safe with similar outcomes.
authors.affiliation: Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, 2131 South 17th Street, PO Box 9025, Wilmington, NC, 28401, USA, william.hope@seahec.net.
authors.forename: W W
authors.initials: WW
authors.lastname: Hope
authors.forename: L
authors.initials: L
authors.lastname: Bools
authors.forename: A
authors.initials: A
authors.lastname: Menon
authors.forename: C M
authors.initials: CM
authors.lastname: Scott
authors.forename: A
authors.initials: A
authors.lastname: Adams
authors.forename: W B
authors.initials: WB
authors.lastname: Hooks
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome