Should hernia operations be carried out on elderly patients?

Abstract

Background. To evaluate whether treatment of the inguinal hernia in patients over 70 years has different connotations with respect to patients of a lower age. Material and methods. Prospective study of 299 patients who had undergone intervention for an uncomplicated unilateral inguinal hernia during the year 2002. Group 1 included 90 patients with an age equal to, or higher than 70 years, and group 2 included the 209 patients who did not exceed this age. The variables studied in the two groups of patients were: type of hernia following the classification of Gilbert – Rutkow-Robbins, percentage of first cases-relapses, technique of repair, type of anaesthesia employed in the intervention, index of substitution in outpatient major surgery and post-operational complications. Results. The two groups were similar with regard to type of hernia, surgical techniques of repair employed and type of anaesthesia employed in the intervention. In spite of the significantly greater anaesthetic risk in the group of patients of greater age (54.4% vs. 7.6% of patients ASA III; p<0.0005), significant differences were not registered between the two groups, either in the index of substitution in out-patient major surgery (80.0% vs. 81.8%) or in the development of complications (3.3% vs. 1.4%). Conclusion. Age is not a factor that alters the good results of the elective inguinal hernioplasty. We would thus not advise against this intervention in elderly patients.