Laparoscopy Versus Open Incarcerated Inguinal Hernia Repair in Octogenarians: Single-Center Experience With World Review.

Objectives: The clinical study is aiming to discuss the therapeutic benefit of laparoscopic hernia (LH) repair with comparing conventional open hernia (OH) repair in incarcerated hernia in octogenarians.

Materials And Methods: The clinical data of 29 octogenarian incarcerated hernia patients who underwent hernia repair from November 2013 to March 2017 were retrospectively analyzed. The variables analyzed include baseline, operation characteristics, and clinical outcomes. The patients were divided into LH and OH according to the surgical approach and their clinical parameters were compared. Descriptive statistics were calculated, and outcomes were compared using the Fisher exact test and the student t test, a P≤0.05 was considered significant.

Results: Of reported 18 octogenarian patients, 7 patients underwent LH, whereas the remaining 11 patients underwent OH. The median age of the patients was 86 (81 to 97). All patients in LH group and 3 patients in OH group underwent nonmesh repair. In total, 8 patients in OH group underwent mesh repair. Simultaneous intestinal resection was needed in 4 patients (2 in LH, 2 in OH) due to the necrotic bowel. No mortality was observed in all subjects. The results showed significantly shorter operation time (50±5 vs. 110±3 min; P=0.000), hospital stay (6±1 vs. 12±3 d; P=0.04). There were no noteworthy postoperative complications and during the follow-up period, no patient experienced recurrent hernia in both groups.

Conclusions: LH nonmesh repair has not increased the morbidity and mortality but showed shorter hospital stay and fast recovery and no recurrence in octogenarian incarcerated hernia patients. Therefore, LH in octogenarian incarcerated hernia patients might be preferred approach in sophisticated hands with acceptable outcomes.