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Is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? Analysis of 24,571 patients from the Herniamed Registry
INTRODUCTION: Several analyses of hernia registries have demonstrated that patients older than 65 years have significantly higher perioperative complication rates compared with patients up to the age of 65. To date, no special analyses of endoscopic/laparoscopic inguinal hernia surgery or of the rel...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710662/ https://www.ncbi.nlm.nih.gov/pubmed/25899813 http://dx.doi.org/10.1007/s00464-015-4209-7 |
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author | Mayer, F. Lechner, M. Adolf, D. Öfner, D. Köhler, G. Fortelny, R. Bittner, R. Köckerling, F. |
author_facet | Mayer, F. Lechner, M. Adolf, D. Öfner, D. Köhler, G. Fortelny, R. Bittner, R. Köckerling, F. |
author_sort | Mayer, F. |
collection | PubMed |
description | INTRODUCTION: Several analyses of hernia registries have demonstrated that patients older than 65 years have significantly higher perioperative complication rates compared with patients up to the age of 65. To date, no special analyses of endoscopic/laparoscopic inguinal hernia surgery or of the relevant additional influence factors have been carried out. Besides, there is no definition to determine whether 65 years should really be considered to be the age limit. METHODS: In the Herniamed Hernia Registry, it was possible to identify 24,571 patients with a primary inguinal hernia and aged at least 16 years who had been operated on between September 1, 2009, and April 15, 2013, using either the TAPP technique (n = 17,214) or TEP technique (n = 7,357). Patients in the age group up to and including 65 years (≤65 years) were compared with those older than 65 years (>65 years) in terms of their perioperative outcome. That was done first using unadjusted analysis and then multivariable analysis. RESULTS: Unadjusted analysis revealed significantly different results for the intraoperative (1.19 vs 1.60 %; p = 0,010), postoperative surgical (2.72 vs 4.59 %; p < 0.001) and postoperative general complications (0.85 vs 1.98 %; p < 0.001) as well as for complication-related reoperations (1.07 vs 1.37 %; p = 0,044), which were more favorable in the ≤65 years age group. However, in multivariable analysis, it was not possible to confirm that for the intraoperative complications or the reoperations. Reoperations were needed more often for bilateral procedures (p < 0.001; OR 2.154 [1.699; 2.730]), higher ASA classification (IV vs I: p = 0.004; OR 6.001 [1.786; 20.167]), larger hernia defect and scrotal hernias. The impact of these factors, in addition to that of age >65 years, was also reflected in the postoperative complication rates. The age limit for increased onset of perioperative complication rates tends to be more than 80 rather than 65 years. CONCLUSION: The higher perioperative complication rate associated with endoscopic/laparoscopic inguinal hernia surgery in patients older than 65 years is of multifactorial genesis and is observed in particular as from the age of 80 years. |
format | Online Article Text |
id | pubmed-4710662 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-47106622016-01-19 Is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? Analysis of 24,571 patients from the Herniamed Registry Mayer, F. Lechner, M. Adolf, D. Öfner, D. Köhler, G. Fortelny, R. Bittner, R. Köckerling, F. Surg Endosc Article INTRODUCTION: Several analyses of hernia registries have demonstrated that patients older than 65 years have significantly higher perioperative complication rates compared with patients up to the age of 65. To date, no special analyses of endoscopic/laparoscopic inguinal hernia surgery or of the relevant additional influence factors have been carried out. Besides, there is no definition to determine whether 65 years should really be considered to be the age limit. METHODS: In the Herniamed Hernia Registry, it was possible to identify 24,571 patients with a primary inguinal hernia and aged at least 16 years who had been operated on between September 1, 2009, and April 15, 2013, using either the TAPP technique (n = 17,214) or TEP technique (n = 7,357). Patients in the age group up to and including 65 years (≤65 years) were compared with those older than 65 years (>65 years) in terms of their perioperative outcome. That was done first using unadjusted analysis and then multivariable analysis. RESULTS: Unadjusted analysis revealed significantly different results for the intraoperative (1.19 vs 1.60 %; p = 0,010), postoperative surgical (2.72 vs 4.59 %; p < 0.001) and postoperative general complications (0.85 vs 1.98 %; p < 0.001) as well as for complication-related reoperations (1.07 vs 1.37 %; p = 0,044), which were more favorable in the ≤65 years age group. However, in multivariable analysis, it was not possible to confirm that for the intraoperative complications or the reoperations. Reoperations were needed more often for bilateral procedures (p < 0.001; OR 2.154 [1.699; 2.730]), higher ASA classification (IV vs I: p = 0.004; OR 6.001 [1.786; 20.167]), larger hernia defect and scrotal hernias. The impact of these factors, in addition to that of age >65 years, was also reflected in the postoperative complication rates. The age limit for increased onset of perioperative complication rates tends to be more than 80 rather than 65 years. CONCLUSION: The higher perioperative complication rate associated with endoscopic/laparoscopic inguinal hernia surgery in patients older than 65 years is of multifactorial genesis and is observed in particular as from the age of 80 years. Springer US 2015-04-22 2016 /pmc/articles/PMC4710662/ /pubmed/25899813 http://dx.doi.org/10.1007/s00464-015-4209-7 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Article Mayer, F. Lechner, M. Adolf, D. Öfner, D. Köhler, G. Fortelny, R. Bittner, R. Köckerling, F. Is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? Analysis of 24,571 patients from the Herniamed Registry |
title | Is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? Analysis of 24,571 patients from the Herniamed Registry |
title_full | Is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? Analysis of 24,571 patients from the Herniamed Registry |
title_fullStr | Is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? Analysis of 24,571 patients from the Herniamed Registry |
title_full_unstemmed | Is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? Analysis of 24,571 patients from the Herniamed Registry |
title_short | Is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? Analysis of 24,571 patients from the Herniamed Registry |
title_sort | is the age of >65 years a risk factor for endoscopic treatment of primary inguinal hernia? analysis of 24,571 patients from the herniamed registry |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710662/ https://www.ncbi.nlm.nih.gov/pubmed/25899813 http://dx.doi.org/10.1007/s00464-015-4209-7 |
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