The Retrospective Analysis Of Causes For Complications After Groin Herniopalsty In Elderly Patients With Different Age

Objective: There is a certain bias in evaluation the operative efficacy by post-operative complications when literature has proved that there are differences in post-operative complications and even mortality among different age groups of elderly and middle-aged patients with inguinal hernia.At the same time,there are also differences in post-operative complications and mortality among different age groups of elderly patients with inguinal hernia.Therefore,comprehensive consideration of the complications and age factors is essential for prerequisites for the objective evaluation of surgical efficacy.At present,there is no accepted age stratification standard,and there is little literature to study the relationship between age stratification and postoperative complications in detail,the present article going to explore it by retrospective research.Methods: The clinical data of 381 patients undergoing tension-free hernioplasty from January 2016 to December 2017 in the Department of Hernia and Abdominal Surgery of the Fourth Affiliated Hospital of China Medical University were retrospectively analyzed.Among 381 patients,86 were under 60 years old,146 were between 60 and 74 years old,107 were between 75 and 84 years old,and 42 were over 85 years old.Seventeen preoperative risk factors were collected from 381 patients,including age,hernia disease information,operation mode,anesthesia,patch type,and multivariate binary logistic regression analysis was performed with three complications: acute urinary retention,poor wound healing and seroma.Result: The elderly inguinal hernia patients with cardiovascular disease,bilateral hernia and defect > 1.5 cm before operation are easy to accept open repair under combined spinal-epidural anesthesia.Patients over 85 years old are prone to acute urinary retention after operation(P =0.016).Patients receiving combined spinal-epidural anesthesia were more likely to have acute urinary retention than those receiving local anesthesia(P = 0.033).Patients with bilateral inguinal hernia were more likely to have acute urinary retention(P =0.021).There was no correlation between the occurrence of acute urinary retention after operation and the way of operation and whether catheter was retained(P > 0.05).Patients over 75 years of age are prone to poor wound healing(P = 0.000). Overweight or obese patients were more likely to have poor wound healing(P = 0.000).Patients who underwent open repair were more likely to have poor wound healing than those who underwent laparoscopic repair(P = 0.003).The occurrence of poor wound healing after operation was not related to patient's activity equivalent,diabetes history and Nyhus hernia type(P > 0.05).Patients over 65 years of age were prone to post-operative seroma(P=0.036).Preoperative patients with cardiovascular disease were more likely to have seroma(P =0.001),incarcerated hernia patients were more likely to have seroma(P=0.008)than non-incarcerated hernia patients.The occurrence of seroma after operation was not related to the operation method,patch type,hernia sac management and unilateral and bilateral hernia(P > 0.05).Conclusion: Patients older than 60 years old,preoperative cardiovascular disease and hernia incarceration are more likely to develop seroma after operation.Patients over 75 years old,obese and undergoing open surgery are more likely to have poor wound healing.Patients older than 85 years,with bilateral hernia and combined spinal-epidural anesthesia are more likely to have acute urinary retention after operation.