Hernia surgery elderly explains emergency hernia surgery carries a high mortality rate in elderly patients as the basis for writing this article
Hernia Surgery Elderly
We need to know that the most common symptom of a hernia is a painful lump or bulge under the skin where the hernia occurs. Hernias can occur at the base or in the stomach and are caused by intestinal or dangerous tissues. Usually the bulge is more pronounced when standing, especially when coughing or straining, and may disappear in the rain or relax. An example is the abdominal hernia caused by the intestine that pushes through the abdominal wall, creating a bulge. This hernia is the organ that forms the body or body on the wall that wraps it. Most of the hernia can be repaired, which means that the hernia can be manipulated back into the abdominal cavity. So, the purpose of this study is to analyze the results. This study conducted five years of abdominal wall management hernia that occurs in the elderly population.
A multicentric retrospective study of all patients with abdominal wall hernias undergoing urgent surgery over a one-year period was conducted in ten hospitals. From April 1990 to December 1995, inguinal, 12 femoral and seven umbilical hernia were improved in 221 patients (mean age 74 (range 66-93) years). Concurrent disease was present in 157 patients. Mesh repair is performed by ‘tension-free’ or ‘plug’ techniques in all but 23 inguinal and two femoral hernia repairs, in which Bassini or Shouldice procedures are adopted. There are ten hernia emergency repairs made for strangulation. A total of 232 surgeries, including four hernia emergency repairs, were performed under local anesthesia. Logistic regression analysis is used to evaluate variables that affect morbidity and mortality.
Thirty-five percent of patients have inguinal hernias, 22% femoral hernia, 20% umbilical hernia, and 15% incisional hernia. Mesh repair is used in 92.5% of cases. Bowel resection is required in 49 patients. Postoperative complications occurred in 130 patients, and 18 patients died (4.5% mortality). Complications and mortality rates were significantly higher in the intestinal resection group. Patients over the age of 70 also show more complications, require more frequent bowel resection, and have higher mortality rates than younger patients. In a logistic regression analysis, age over 70 years, bowel resection, and the American Society of Anesthesiologists (ASA) III / IV class emerged as independent predictors of poor outcomes. Based on our results, we propose a simple scheme to calculate the risk of death in these patients.
Emergency hernia surgery carries a high mortality rate in elderly patients. Using multivariate logistic regression analysis, the probability of death following complicated abdominal wall hernia surgery was increased in patients with: age above 70 years, high ASA grade, and associated bowel resection. Patients over the age of 70 also show more complications, require more frequent bowel resection, and have higher mortality rates than younger patients. Improvement of the initial elective hernia is highly recommended.
Hernia surgery; Old; Abdominal hernia
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