C E H Voorbrood1, J P J Burgmans2, G J Clevers2, P H P Davids2, E J M M Verleisdonk2, T van Dalen2. 1. Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands. cvoorbrood@diakhuis.nl. 2. Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands.
Abstract
BACKGROUND: Inguinal hernias are common in elderly males. We addressed outcome following totally extraperitoneal (TEP) hernia repair in patients older than 70 years. METHODS: We prospectively collected data of patients >70 years with a unilateral or bilateral inguinal hernia operated in our hospital between January 2005 and January 2010 using the TEP technique. RESULTS: A total of 429 patients underwent TEP hernia repair under general anaesthesia, mostly men (n = 405; 94.4%). Median age was 74 years (range 70-89). The mean pre-operative pain score was 3.7 (SD ± 2.5). Ninety-four percent of patients had an ASA score of 1 or 2. Three hundred thirty-six patients underwent a unilateral repair (78%). The conversion rate to an anterior procedure was 0.7 % (n = 3). In 8 patients (1.9%), intra-operative complications occurred, and the postoperative course was complicated in 3 patients (0.7 %). Severe complications attributable to the endoscopic approach occurred in 6 patients (1.4%): a bladder injury (n = 5) and a trocar-induced bowel perforation (n = 1). The mean postoperative pain score after 6 weeks was 1.6 (SD ± 1.2). Patients were able to resume their daily activities after a median of 7 days (range 1-42). CONCLUSION: Totally, extraperitoneal endoscopic inguinal hernia repair in elderly patients is associated with low overall complication rates and a fast recovery. In a small proportion of patients, severe complications occur attributable to the endoscopic approach.
BACKGROUND: Inguinal hernias are common in elderly males. We addressed outcome following totally extraperitoneal (TEP) hernia repair in patients older than 70 years. METHODS: We prospectively collected data of patients >70 years with a unilateral or bilateral inguinal hernia operated in our hospital between January 2005 and January 2010 using the TEP technique. RESULTS: A total of 429 patients underwent TEP hernia repair under general anaesthesia, mostly men (n = 405; 94.4%). Median age was 74 years (range 70-89). The mean pre-operative pain score was 3.7 (SD ± 2.5). Ninety-four percent of patients had an ASA score of 1 or 2. Three hundred thirty-six patients underwent a unilateral repair (78%). The conversion rate to an anterior procedure was 0.7 % (n = 3). In 8 patients (1.9%), intra-operative complications occurred, and the postoperative course was complicated in 3 patients (0.7 %). Severe complications attributable to the endoscopic approach occurred in 6 patients (1.4%): a bladder injury (n = 5) and a trocar-induced bowel perforation (n = 1). The mean postoperative pain score after 6 weeks was 1.6 (SD ± 1.2). Patients were able to resume their daily activities after a median of 7 days (range 1-42). CONCLUSION: Totally, extraperitoneal endoscopic inguinal hernia repair in elderly patients is associated with low overall complication rates and a fast recovery. In a small proportion of patients, severe complications occur attributable to the endoscopic approach.
Authors: N Schouten; R K J Simmermacher; T van Dalen; N Smakman; G J Clevers; P H P Davids; E J M M Verleisdonk; J P J Burgmans Journal: Surg Endosc Date: 2012-10-06 Impact factor: 4.584
Authors: L S Rasmussen; T Johnson; H M Kuipers; D Kristensen; V D Siersma; P Vila; J Jolles; A Papaioannou; H Abildstrom; J H Silverstein; J A Bonal; J Raeder; I K Nielsen; K Korttila; L Munoz; C Dodds; C D Hanning; J T Moller Journal: Acta Anaesthesiol Scand Date: 2003-03 Impact factor: 2.105
Authors: M P Simons; T Aufenacker; M Bay-Nielsen; J L Bouillot; G Campanelli; J Conze; D de Lange; R Fortelny; T Heikkinen; A Kingsnorth; J Kukleta; S Morales-Conde; P Nordin; V Schumpelick; S Smedberg; M Smietanski; G Weber; M Miserez Journal: Hernia Date: 2009-07-28 Impact factor: 4.739