Outcomes of laparoscopic transabdominal preperitoneal hernia repair in the elderly population: a retrospective cohort study

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Abstract

INTRODUCTION:

Hernia repair is a common procedure, especially among the elderly. In the face of rising life expectancy, adequate hernia management in older adults is crucial. Laparoscopic transabdominal preperitoneal patch plasty (TAPP) for hernia repair is minimally invasive, but poses challenges in the elderly due to a larger number of comorbidities.

AIM:

The aim of this study was to evaluate the safety and efficacy of TAPP hernia repair in patients aged 70 years and older.

MATERIALS AND METHODS:

Our retrospective study reviewed data of patients who underwent elective unilateral TAPP repair for primary inguinal hernia between September 2021 and December 2023. The patients were divided by age: 70 and older (cases) and younger than 70 (controls). Primary outcomes included recurrence rate, surgical site infections (SSIs), operative time, and hospital stay. Data were analyzed with descriptive statistics and inferential tests.

RESULTS:

The study included 201 patients (47 cases and 154 controls). The mean (SD) age was 75.74 (4.73) years for the cases and 53.47 (12.8) years for the controls. No recurrences were found in the elderly (cases) group, while the control group recorded a 3.92% recurrence rate ( P = 0.34). SSIs affected 2.13% of the cases and 1.31% of the controls ( P = 0.55). Operative times were similar (71.44 vs 71.96 min; P = 0.8) . Hospital stay was 3.11 days for the cases and 3.04 days for the controls ( P = 0.14).

CONCLUSIONS:

Laparoscopic TAPP hernia repair is a safe and effective procedure in the elderly and its outcomes are comparable to those recorded in younger patients. Further studies are needed to validate these results.

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Most cited references 21

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The STROBE guidelines

Sarah Cuschieri (2019)

An observational study is a type of epidemiological study design, which can take the form of a cohort, a case–control, or a cross-sectional study. When presenting observational studies in manuscripts, an author needs to ascertain a clear presentation of the work and provide the reader with appropriate information to enable critical appraisal of the research. The Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines were created to aid the author in ensuring high-quality presentation of the conducted observational study. The original articles publishing the STROBE guidelines together with their bibliographies were identified and thoroughly reviewed. These guidelines consist of 22 checklist items that the author needs to fulfil before submitting the manuscript to a journal. The STROBE guidelines were created to aid the authors in presenting their work and not to act as a validation tool for the conducted study or as a framework to conduct an observational study on. The authors complying with these guidelines are more likely to succeed in publishing their observational study work in a journal.

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European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

M. P. Simons, T. Aufenacker, M Bay-Nielsen … (2009)

The European Hernia Society (EHS) is proud to present the EHS Guidelines for the Treatment of Inguinal Hernia in Adult Patients. The Guidelines contain recommendations for the treatment of inguinal hernia from diagnosis till aftercare. They have been developed by a Working Group consisting of expert surgeons with representatives of 14 country members of the EHS. They are evidence-based and, when necessary, a consensus was reached among all members. The Guidelines have been reviewed by a Steering Committee. Before finalisation, feedback from different national hernia societies was obtained. The Appraisal of Guidelines for REsearch and Evaluation (AGREE) instrument was used by the Cochrane Association to validate the Guidelines. The Guidelines can be used to adjust local protocols, for training purposes and quality control. They will be revised in 2012 in order to keep them updated. In between revisions, it is the intention of the Working Group to provide every year, during the EHS annual congress, a short update of new high-level evidence (randomised controlled trials [RCTs] and meta-analyses). Developing guidelines leads to questions that remain to be answered by specific research. Therefore, we provide recommendations for further research that can be performed to raise the level of evidence concerning certain aspects of inguinal hernia treatment. In addition, a short summary, specifically for the general practitioner, is given. In order to increase the practical use of the Guidelines by consultants and residents, more details on the most important surgical techniques, local infiltration anaesthesia and a patient information sheet is provided. The most important challenge now will be the implementation of the Guidelines in daily surgical practice. This remains an important task for the EHS. The establishment of an EHS school for teaching inguinal hernia repair surgical techniques, including tips and tricks from experts to overcome the learning curve (especially in endoscopic repair), will be the next step. Working together on this project was a great learning experience, and it was worthwhile and fun. Cultural differences between members were easily overcome by educating each other, respecting different views and always coming back to the principles of evidence-based medicine. The members of the Working Group would like to thank the EHS board for their support and especially Ethicon for sponsoring the many meetings that were needed to finalise such an ambitious project.

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The European hernia society groin hernia classification: simple and easy to remember.

M. Miserez, J. Alexandre, G. Campanelli … (2007)

After reviewing the available classifications for groin hernias, the European Hernia Society (EHS) proposes an easy and simple classification based on the Aachen classification. The EHS will promote the general and systematic use of this classification for intraoperative description of the type of hernia and to increase the comparison of results in the literature.

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Author and article information

Contributors

Dawid Golik: Poland

Krzysztof Jędras: Poland

Przemysław Sroczyński: Poland

Grzegorz Dobkowski: Poland

Michał R. Janik: Poland , +48 261852953 , janiken@gmail.com

Journal

Journal ID (nlm-ta): Wideochir Inne Tech Maloinwazyjne

Journal ID (iso-abbrev): Wideochir Inne Tech Maloinwazyjne

Journal ID (issn): 2299-0054

Title: Videosurgery and other Miniinvasive Techniques

Publisher: Wideochir Inne Tech Maloinwazyjne

ISSN (Print): 1895-4588

ISSN (Electronic): 2299-0054

Publication date (Electronic, pub): 20 September 2024

Publication date (Electronic, collection): 16 October 2024

Volume: 19

Issue: 3

Pages: 325-329

Affiliations

General Surgery Department, Military Institute of Aviation Medicine, Warszawa, Poland

General Surgery Department, Hospital of Our Lady of Perpetual Help, Wołomin, Poland

Author notes

CONFLICT OF INTEREST: None declared.

Corresponding author: Michał R. Janik, General Surgery Department, Military Institute of Aviation Medicine, Warszawa, Poland .Email: janiken@ 123456gmail.com . Phone number:+48 261852953

Article

DOI: 10.20452/wiitm.2024.17899

PMC ID: 11927547

SO-VID: 7e6dad7e-6ead-465d-a03d-2803f9223df6

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 5 July 2024

Date revision received : 12 September 2024

Funding

None.

Open Access :

This is an Open Access article distributed under the terms of the Creative Commons Attribution‐NonCommercial‐ShareAlike 4.0 International License (CC BY‐NC‐SA 4.0), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited, distributed under the same license, and used for noncommercial purposes only.

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Keywords: elderly,hernia repair,laparoscopic surgery,outcomes,transabdominal preperitoneal hernia repair

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Keywords: elderly, hernia repair, laparoscopic surgery, outcomes, transabdominal preperitoneal hernia repair

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Outcomes of laparoscopic transabdominal preperitoneal hernia repair in the elderly population: a retrospective cohort study

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Abstract

INTRODUCTION:

AIM:

MATERIALS AND METHODS:

RESULTS:

CONCLUSIONS:

Related collections

The Journal of Population and Sustainability

Most cited references 21

The STROBE guidelines

European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

The European hernia society groin hernia classification: simple and easy to remember.

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