Hernias externas incarceradas en pacientes octogenarios

The outcomes of open tension-free hernioplasty in elderly patients

BACKGROUND

The outcomes of open tension-free hernioplasty have been evaluated for elderly patients and compared with other techniques without prosthesis or analyzed in elderly patients without a control group constituted by younger patients. Our aim was to compare the outcomes of open tension-free hernioplasty between elderly patients and younger patients applying the recently developed Quantitative and Qualitative Measurement Instrument (QQMI).

METHODS

From January 1997 to December 2003, 731 male patients were electively operated on for inguinal hernia at our institution. We studied 688 patients (94%). Forty-three (6%) were excluded: 12 died of causes unrelated to inguinal surgery and 31 were lost to follow-up. The follow-up period ranged from 22 to 106 months, mean 87 +/- 8.5 months.

RESULTS

Recurrence developed in seven patients (1%): six were patients younger than 70 years old. The final mean QQMI score for patients younger than 70 years old was 10.4, significantly higher than the score of 8.9 for elderly patients.

CONCLUSION

The outcomes of open tension-free hernioplasty were better in patients younger than 70 years old than the outcomes for elderly patients.

Are the outcomes of emergency Lichtenstein hernioplasty similar to the outcomes of elective Lichtenstein hernioplasty?

BACKGROUND

The safe use of polypropylene prosthesis for the repair of complicated inguinal hernias has been established even when small bowel resection was required. Few reports have completely addressed this subject; none have compared the outcomes of emergency and elective Lichtenstein hernioplasty.

METHODS

From January 2001 to December 2003, 343 patients were electively operated for inguinal hernia and 62 for complicated inguinal hernia. A follow-up period of 17-57 months using the Quantitative and Qualitative Measurement Instrument for evaluation of Lichtenstein hernioplasty outcomes (QQMI) was completed for 48 emergency patients and 326 elective patients.

RESULTS

The mean QQMI score showed that most patients felt that the outcomes of their surgery were very good or excellent. Mean QQMI score for elective surgery was 10.1 and 9.5 for emergency surgery.

CONCLUSIONS

The outcomes of emergency Lichtenstein hernioplasty were inferior to the outcomes of elective Lichtenstein hernioplasty.