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Feasibility of totally extraperitoneal (TEP) laparoscopic hernia repair in elderly patients

Authors
  • Chung, Y.1
  • Choi, J. W.2
  • Kim, H. C.2
  • Kim, S. H.2
  • Choi, S. I.2
  • 1 Kyung Hee University, Department of Surgery, Graduate School, Seoul, South Korea , Seoul (South Korea)
  • 2 Kyung Hee University Hospital at Gangdong, Department of Surgery, Kyung Hee University School of Medicine, Dongnam-ro 892, Gangdong-gu, Seoul, South Korea , Seoul (South Korea)
Type
Published Article
Journal
Hernia
Publisher
Springer Paris
Publication Date
Dec 03, 2018
Volume
23
Issue
2
Pages
299–303
Identifiers
DOI: 10.1007/s10029-018-1869-y
Source
Springer Nature
Keywords
License
Yellow

Abstract

IntroductionLaparoscopic total extraperitoneal peritoneal (TEP) repair has become increasingly popular since its introduction. The purpose of this study is to establish the safety and feasibility of TEP in elderly patients compared to that in younger patients.MethodsThe clinical records of patients who received TEP hernia repair from August 2007 to September 2016 were reviewed. The patients were categorized into two groups: younger than 70 and 70 years or older. The patient demographics, operative time, estimated blood loss, rate of open conversion, complications, length of hospital stay, rate of readmission, rate of recurrence were compared.ResultsA total of 425 cases were documented. 317 (74.6%) patients were younger than 70 years and 108 (25.4%) were 70 years or older. The mean ages were 51.6 years in the younger group and 75.3 years in the older group. Co-morbidities (34.0% vs 72.2%, p = 0.000) and ASA score III and IV (4.1% vs. 6.5%, p value = 0.000) were more common in the elderly group. There were no significant differences between the two groups in the percentage of history of previous surgery in the lower abdominal region (23.9% vs 29.6%, p = 0.292), overall complications (7.2% vs 12.7%, p value = 0.177), and anesthesia-related complications (0% vs 1%, p value = 0.617). The operative time was similar between the two groups (54.3 vs 57.1 p = 0.220). The length of hospital stay (2.7 vs 3.0, p = 0.022) was longer in the elderly group.ConclusionsLaparoscopic TEP hernia repair can be performed safely in elderly patients without differences in perioperative complications and recurrence rate compared to that in a younger population despite a longer hospital stay.

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