title: Laparoscopic Totally Extraperitoneal Inguinal Hernia Repair in the Elderly: A Prospective Control Study.
abstract: Inguinal hernia (IH) repair can be obtained with both open and laparoscopic techniques, which are usually performed using a transabdominal preperitoneal (TAPP) or a totally extraperitoneal (TEP) approach. The aim of the study was to evaluate whether the results of laparoscopic TEP IH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. One hundred and four consecutive patients (four women and 100 men, median age of 57 years, range=21-85 years) with unilateral (N=21, 20.2%) or bilateral (N=83, 79.8%) IH were prospectively enrolled in the study. Patients were divided into two groups according to their age: group A (N=68, 65.4%) aged <65 years and group B (N=36, 34.6%) aged ≥65 years. The mean operative time was not significantly different between groups (48±20 vs. 52±20 min, p=0.33). One case of increased PaCO2 was observed in each group (p=0.72) and two and one case of pneumoperitoneum (p=0.57) in groups A and B, respectively. Two (1.9%) patients (one in each group; p=0.55) required TEP conversion. Mild postoperative complications developed in four patients of each group (p=0.44). After one-year follow-up, three (2.9%) recurrences occurred (group 1=1, group 2=2, p=0.55), both in patients who had undergone direct IH repair. The overall postoperative relative risk of complications related to age was 1.08 (95% confidence interval=0.91-1.27, p=0.53). In conclusion, our results suggest that in patients with IH scheduled for TEP repair, age does not represent a contraindication to surgery in terms of complication rate and postoperative results.
authors.affiliation: General Surgery, S. Maria del Carmine Hospital, Rovereto, Italy simonezanella@apss.tn.it.
authors.forename: Simone
authors.initials: S
authors.lastname: Zanella
authors.affiliation: General Surgery, S. Maria del Carmine Hospital, Rovereto, Italy.
authors.forename: Antonios
authors.initials: A
authors.lastname: Vassiliadis
authors.affiliation: Department of Emergency, S. Chiara Hospital, Trento, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Buccelletti
authors.affiliation: General Surgery, S. Maria del Carmine Hospital, Rovereto, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Lauro
authors.affiliation: General Surgery, S. Maria del Carmine Hospital, Rovereto, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ricci
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, University of Padua, School of Medicine, Padova, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Lumachi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Elderly; TAPP; TEP; inguinal hernia; inguinal hernia repair; laparoscopic repair; totally extraperitoneal repair