Abstract

CUENCA TORRES, O  and  SEGUNDA CATEDRA DE CLINICA QUIRURGICA. HOSPITAL DE CLINICAS. FACULTAD DE CIENCIAS MEDICAS UNIVERSIDAD NACIONAL DE ASUNCION et al. Hernioplasty in elderly patients. An. Fac. Cienc. Méd. (Asunción) [online]. 2011, vol.44, n.2, pp.15-22. ISSN 1816-8949.

ABSTRACT Introduction: inguinal hernia is a common condition in elderly patients and age alone is not a factor that contraindicates surgery with tension-free techniques in this age group, although it is often associated with other pathologies that are in most cases stabilized. Surgical intervention in this group of patients as an emergency it could mean an increase in morbidity and mortality. Objective: To describe the results of surgical treatment of inguinal hernia with tension-free techniques in elderly patients. Patients and Methods: Descriptive observational study, 250 patients longitudinally over 60 years, suffering of inguinal hernia, surgically treated with tension-free technique, as elective or emergency surgeries in the abdominal wall department at the Second Chair of Clinical Surgery, Faculty of Medical Sciences, National University of Asuncion, from January 1998 to December 2010. Variables: age, sex, type of hernia, presentation, associated diseases, classification of Gilbert, anesthesia used, hospital stay, local complications and follow-up to 24 months. Results: 250 patients were operated predominantly male, aged 60-90 years (mean 75 years), with associated pathologies in 53 patients (21%), predominantly heart disease as the underlying pathology. 220 (88%) were primary hernias and 30 (12%) were recurrent. As for the presentation 218 patients (87.2%) presented with uncomplicated hernia, 18 (7.2%) were incarcerated and 14 (5.6%) had strangulation. According to Gilbert's classification, the type III was the most frequent in 51.6% (129 patients). Mean hospital stay was 21.4 hours with local complications in 12 patients (4.8%). Follow-up was 19 months satisfactory in 60% of cases without evidence of recurrence or mortality. Conclusion: The use of tension-free techniques to surgically treat inguinal hernia in elderly patients gives similar results in terms of local complications and recurrence in other age groups. Keywords: hernia, hernioplasty, elderly patients

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