Abstract
Purpose: In this study morbidity and mortality rates of inguinal and femoral hernia repair operations carried out under emergency and elective conditions on patients of 65 years and older ages are evaluated. Materials and Methods: Two hundred and seven patients of 65 years and older, who were operated on under emergency and elective conditions for inguinal and femoral hernia within the 10 years period between 1999 and 2009, were included in this study. Of these patients, 51 were operated on under emergency conditions while the other 156 were operated on under elective conditions. To compare the ratio of groups, the chi-square test and for comparing the quantitative variables the student's t test was used. Results: There was no significant difference between the groups in terms of co-morbid diseases (p=0.950). While no morbidity was seen among patients operated on under elective conditions, 5 of the patients who were operated on under emergency conditions were lost due to various complications (p<0.001). While the patients who were operated on under emergency conditions spent an average time of 8 days in hospital, this time was 3 da ys for those operated on under elective conditions (p<0.001). Conclusion: As morbidity and mortality rates and hospital staying time were found to be high with patients of advanced age who were diagnosed with inguinal or femoral hernias and operated on in emergency conditions, surgical interventions are advised to be carried out under selective conditions.
Keywords: Old patients, inguinal hernia, mortality and morbidity
References
Türkiye İstatistik Kurumu, Adrese Dayalı Nüfus Kayıt Sistemi, Nüfus Sayımı 2009.
Gavrilenko BG, Bannyi AV, Pagava AZ, et al. Surgical treatment of inguinal hernias in the elderly and very old patients. Klin Khir 1992; 2: 29-31.
Vatansev C, Tekin A. Yaşlılarda Fıtık Cerrahisi. Turkiye Klinikleri J Surg Med Sci 2006; 2: 86-88.
Zenilman ME. Surgery in the elderly. Curr Probl Surg 1998; 35: 99-178. http://dx.doi.org/10.1016/S0011- 3840(98)80003-8 [CrossRef]
Fitzgibbens RJ, Filipi C, Quinn TH. İn eds Schwartz S. Cerrahinin İlkeleri İnguinal Herniler Çev. Ed. Geçim İE, Demirkıran A. 8. Baskı 2008; 1401-1443.
Groin Hernia Surgery. The Surgical clinics of North America December 1998.
Mayir B, Altınel Ö, Özerhan İH, ve ark. Yaşlı hastalarda cerrahi sonrası mortaliteye etki eden faktörler. Anatol J Clin Investig 2010: 4: 32-35.
Devlin HB, Kingsnorth A. Management of Abdominal hernias. 2. ed. Lippincott Williams and Wilkins, London 1988.s.105.
Williams JS, Hale HW. The advisability of inguinal herniorrapy in the elderly. Surg Gynecol Obstet 1966; 122: 100-104.
Nehme AE. Groin hernias in elderly patients: management and prognosis. Am J Surg 1983; 146: 257-260. http://dx.doi. org/10.1016/0002-9610(83)90386-0 [CrossRef]
Kekeç Y, Alparslan A, Demirtaş S, ve ark. İrredüktibl fıtıklarda strangülasyonun morbidite ve mortalite hızına etkileri. UCD 1993; 9: 128-131.
Allen PIM, Zager M, Goldman M. Elective repair of groin hernias in the elderly. Br J Surg 1987; 74: 987. http://dx.doi. org/10.1002/bjs.1800741109 [CrossRef]
Kulaçoğlu İH, Polat A, Moran M, ve ark. İleri Yaş Grubunda Elektif İnguinal Herni Onarımı. Turkish Journal of Geriatrics Geriatri 2000; 3: 64-68.
Pavlidis TE, Symeonidis NG, Rafailidis SF, et al. Tension-free by mesh-plug technique for inguinal hernia repair in elderly patients. Scand J Surg 2010; 99: 137-41.
Ribeiro FA, Padron F, Castro TD, et al. Inguinal hernia repair with local anesthesia in the outpatient. Clinica Cirúrgica, Hospital Geral de Bonsucesso, Rio de Janeiro, RJ, BR. Rev Col Bras Cir 2010; 37: 397-402. http://dx.doi.org/10.1590/ S0100-69912010000600004 [CrossRef]
