Inguinal hernia repair in a community setting: implications for the elderly
Objective Inguinal hernia repair is thought to be a relatively low morbidity operation. This study examined whether this tenet hold true in patients who are elderly with significant comorbidity. Design Case series. Retrospective review of a prospectively collected database. Setting Single surgeon pr...
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| Veröffentlicht in: | Hernia : the journal of hernias and abdominal wall surgery 2011-02, Vol.15 (1), p.37-42 |
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| container_title | Hernia : the journal of hernias and abdominal wall surgery |
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| creator | Rogers, F. B. Guzman, E. A. |
| description | Objective
Inguinal hernia repair is thought to be a relatively low morbidity operation. This study examined whether this tenet hold true in patients who are elderly with significant comorbidity.
Design
Case series. Retrospective review of a prospectively collected database.
Setting
Single surgeon practicing in Vermont over a period of 9 years.
Patients
Consecutive sample of 2,145 inguinal herniorraphies in 1,889 patients.
Intervention
Patients underwent an open inguinal hernia repair with mesh placement. A total of 81% of the repairs were performed under local anesthesia with intravenous sedation.
Main outcome measure
Presence of comorbid conditions and complications were compared between patients younger and older than 65 years.
Results
A total of 2,145 herniorraphies were performed on 1,889 patients (1,646 in younger patients and 499 in older patients). Hernia repairs in older patients were more likely associated with comorbid conditions than in their younger counterparts (74 vs 39%; OR = 4.55,
P
|
| doi_str_mv | 10.1007/s10029-010-0733-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_851751809</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2265341351</sourcerecordid><originalsourceid>FETCH-LOGICAL-c436t-574c0e32b1158229b7692bd5efb2bd2fbeccece685ea1d8063ac4f3b12362e1a3</originalsourceid><addsrcrecordid>eNp1kD1PwzAQhi0EoqXwA1iQxcIU8EfsOGyo4ktUYoHZctxL6ypxip0M_fe4tICExHJ3kp97rXsQOqfkmhJS3MRUWZkRSjJScJ6JAzSmLFdZyUh-uJ2lyPKSyBE6iXFFCFG5VMdoxEjJJadijF6e_WJw3jR4CcE7gwOsjQvYeWyw7dp28K7f4Ah97_ziFrt23Thretf5iOsu4H4JGJo5hGZzio5q00Q42_cJen-4f5s-ZbPXx-fp3SyzOZd9JorcEuCsolQoxsqqkCWr5gLqKjVWV2AtWJBKgKFzRSQ3Nq95RRmXDKjhE3S1y12H7mOA2OvWRQtNYzx0Q9RK0EJQlW6coMs_5KobQrr2C8q5IqxIEN1BNnQxBqj1OrjWhI2mRG89651nnTzrrWct0s7FPnioWpj_bHyLTQDbATE9-QWE35__T_0EK3aH-w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>851438027</pqid></control><display><type>article</type><title>Inguinal hernia repair in a community setting: implications for the elderly</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Rogers, F. B. ; Guzman, E. A.</creator><creatorcontrib>Rogers, F. B. ; Guzman, E. A.</creatorcontrib><description>Objective
Inguinal hernia repair is thought to be a relatively low morbidity operation. This study examined whether this tenet hold true in patients who are elderly with significant comorbidity.
Design
Case series. Retrospective review of a prospectively collected database.
Setting
Single surgeon practicing in Vermont over a period of 9 years.
Patients
Consecutive sample of 2,145 inguinal herniorraphies in 1,889 patients.
Intervention
Patients underwent an open inguinal hernia repair with mesh placement. A total of 81% of the repairs were performed under local anesthesia with intravenous sedation.
Main outcome measure
Presence of comorbid conditions and complications were compared between patients younger and older than 65 years.
Results
A total of 2,145 herniorraphies were performed on 1,889 patients (1,646 in younger patients and 499 in older patients). Hernia repairs in older patients were more likely associated with comorbid conditions than in their younger counterparts (74 vs 39%; OR = 4.55,
P
< 0.0001). Specifically, hypertension (26 vs 9%; OR = 3.5,
P
< 0.0001), coronary artery disease (34 vs 6%; OR = 8.4,
P
< 0.0001) and benign prostatic hypertrophy (26 vs 4%; OR = 8.2,
P
< 0.0001) were more commonly present in older individuals. The commonest postoperative complications in both groups were recurrence (3%), hematoma (1%) and nerve entrapment (1%). There were no deaths. There was no significant difference in the rate of postoperative complications (6 vs 7%; OR = 0.95,
P
= 0.88) or recurrence rates (2 vs 3%; OR = 0.82,
P
= 0.65) between groups.
Conclusion
Inguinal herniorrhaphy under local anesthesia is a safe operation with a high success rate in the elderly. Patients with significant comorbidities are not at higher risk of complications or recurrences.</description><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-010-0733-5</identifier><identifier>PMID: 20936315</identifier><language>eng</language><publisher>Paris: Springer-Verlag</publisher><subject>Abdominal Surgery ; Aged ; Comorbidity ; Delivery of Health Care ; Elective Surgical Procedures - statistics & numerical data ; Female ; Hernia, Inguinal - surgery ; Humans ; Intraoperative Complications ; Male ; Medicine ; Medicine & Public Health ; Multivariate Analysis ; Original Article ; Postoperative Complications ; Recurrence ; Retrospective Studies</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2011-02, Vol.15 (1), p.37-42</ispartof><rights>Springer-Verlag 2010</rights><rights>Springer-Verlag 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-574c0e32b1158229b7692bd5efb2bd2fbeccece685ea1d8063ac4f3b12362e1a3</citedby><cites>FETCH-LOGICAL-c436t-574c0e32b1158229b7692bd5efb2bd2fbeccece685ea1d8063ac4f3b12362e1a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10029-010-0733-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10029-010-0733-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20936315$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rogers, F. B.</creatorcontrib><creatorcontrib>Guzman, E. A.</creatorcontrib><title>Inguinal hernia repair in a community setting: implications for the elderly</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Objective
Inguinal hernia repair is thought to be a relatively low morbidity operation. This study examined whether this tenet hold true in patients who are elderly with significant comorbidity.
Design
Case series. Retrospective review of a prospectively collected database.
Setting
Single surgeon practicing in Vermont over a period of 9 years.
Patients
Consecutive sample of 2,145 inguinal herniorraphies in 1,889 patients.
Intervention
Patients underwent an open inguinal hernia repair with mesh placement. A total of 81% of the repairs were performed under local anesthesia with intravenous sedation.
Main outcome measure
Presence of comorbid conditions and complications were compared between patients younger and older than 65 years.
Results
A total of 2,145 herniorraphies were performed on 1,889 patients (1,646 in younger patients and 499 in older patients). Hernia repairs in older patients were more likely associated with comorbid conditions than in their younger counterparts (74 vs 39%; OR = 4.55,
P
< 0.0001). Specifically, hypertension (26 vs 9%; OR = 3.5,
P
< 0.0001), coronary artery disease (34 vs 6%; OR = 8.4,
P
< 0.0001) and benign prostatic hypertrophy (26 vs 4%; OR = 8.2,
P
< 0.0001) were more commonly present in older individuals. The commonest postoperative complications in both groups were recurrence (3%), hematoma (1%) and nerve entrapment (1%). There were no deaths. There was no significant difference in the rate of postoperative complications (6 vs 7%; OR = 0.95,
P
= 0.88) or recurrence rates (2 vs 3%; OR = 0.82,
P
= 0.65) between groups.
Conclusion
Inguinal herniorrhaphy under local anesthesia is a safe operation with a high success rate in the elderly. Patients with significant comorbidities are not at higher risk of complications or recurrences.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Comorbidity</subject><subject>Delivery of Health Care</subject><subject>Elective Surgical Procedures - statistics & numerical data</subject><subject>Female</subject><subject>Hernia, Inguinal - surgery</subject><subject>Humans</subject><subject>Intraoperative Complications</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate Analysis</subject><subject>Original Article</subject><subject>Postoperative Complications</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><issn>1265-4906</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kD1PwzAQhi0EoqXwA1iQxcIU8EfsOGyo4ktUYoHZctxL6ypxip0M_fe4tICExHJ3kp97rXsQOqfkmhJS3MRUWZkRSjJScJ6JAzSmLFdZyUh-uJ2lyPKSyBE6iXFFCFG5VMdoxEjJJadijF6e_WJw3jR4CcE7gwOsjQvYeWyw7dp28K7f4Ah97_ziFrt23Thretf5iOsu4H4JGJo5hGZzio5q00Q42_cJen-4f5s-ZbPXx-fp3SyzOZd9JorcEuCsolQoxsqqkCWr5gLqKjVWV2AtWJBKgKFzRSQ3Nq95RRmXDKjhE3S1y12H7mOA2OvWRQtNYzx0Q9RK0EJQlW6coMs_5KobQrr2C8q5IqxIEN1BNnQxBqj1OrjWhI2mRG89651nnTzrrWct0s7FPnioWpj_bHyLTQDbATE9-QWE35__T_0EK3aH-w</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>Rogers, F. B.</creator><creator>Guzman, E. A.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20110201</creationdate><title>Inguinal hernia repair in a community setting: implications for the elderly</title><author>Rogers, F. B. ; Guzman, E. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-574c0e32b1158229b7692bd5efb2bd2fbeccece685ea1d8063ac4f3b12362e1a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Comorbidity</topic><topic>Delivery of Health Care</topic><topic>Elective Surgical Procedures - statistics & numerical data</topic><topic>Female</topic><topic>Hernia, Inguinal - surgery</topic><topic>Humans</topic><topic>Intraoperative Complications</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate Analysis</topic><topic>Original Article</topic><topic>Postoperative Complications</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rogers, F. B.</creatorcontrib><creatorcontrib>Guzman, E. A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rogers, F. B.</au><au>Guzman, E. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inguinal hernia repair in a community setting: implications for the elderly</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>15</volume><issue>1</issue><spage>37</spage><epage>42</epage><pages>37-42</pages><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>Objective
Inguinal hernia repair is thought to be a relatively low morbidity operation. This study examined whether this tenet hold true in patients who are elderly with significant comorbidity.
Design
Case series. Retrospective review of a prospectively collected database.
Setting
Single surgeon practicing in Vermont over a period of 9 years.
Patients
Consecutive sample of 2,145 inguinal herniorraphies in 1,889 patients.
Intervention
Patients underwent an open inguinal hernia repair with mesh placement. A total of 81% of the repairs were performed under local anesthesia with intravenous sedation.
Main outcome measure
Presence of comorbid conditions and complications were compared between patients younger and older than 65 years.
Results
A total of 2,145 herniorraphies were performed on 1,889 patients (1,646 in younger patients and 499 in older patients). Hernia repairs in older patients were more likely associated with comorbid conditions than in their younger counterparts (74 vs 39%; OR = 4.55,
P
< 0.0001). Specifically, hypertension (26 vs 9%; OR = 3.5,
P
< 0.0001), coronary artery disease (34 vs 6%; OR = 8.4,
P
< 0.0001) and benign prostatic hypertrophy (26 vs 4%; OR = 8.2,
P
< 0.0001) were more commonly present in older individuals. The commonest postoperative complications in both groups were recurrence (3%), hematoma (1%) and nerve entrapment (1%). There were no deaths. There was no significant difference in the rate of postoperative complications (6 vs 7%; OR = 0.95,
P
= 0.88) or recurrence rates (2 vs 3%; OR = 0.82,
P
= 0.65) between groups.
Conclusion
Inguinal herniorrhaphy under local anesthesia is a safe operation with a high success rate in the elderly. Patients with significant comorbidities are not at higher risk of complications or recurrences.</abstract><cop>Paris</cop><pub>Springer-Verlag</pub><pmid>20936315</pmid><doi>10.1007/s10029-010-0733-5</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 1265-4906 |
| ispartof | Hernia : the journal of hernias and abdominal wall surgery, 2011-02, Vol.15 (1), p.37-42 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Aged Comorbidity Delivery of Health Care Elective Surgical Procedures - statistics & numerical data Female Hernia, Inguinal - surgery Humans Intraoperative Complications Male Medicine Medicine & Public Health Multivariate Analysis Original Article Postoperative Complications Recurrence Retrospective Studies |
| title | Inguinal hernia repair in a community setting: implications for the elderly |
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