The Feasibility And Safety Of Elective Transabdominal Preperitoneal Prosthetic Groin Hernia Repair In The Elderly

Objective: To explore the clinical efficacy and safety of TAPP in the real world in elderly patients with inguinal hernia in the real world.Methods:We retrospectively analyzed the patients with inguinal hernia who underwent508 TAPP procedures continuously performed in liaoning provincial hernia treatment center on October 01,2015,solstice,2019,December 1,2019.They were divided into four groups,45-59 years old,60-74 years old,75-84 years old and over 85 years old.According to gender,ASA grade,coexisting basic disease status,body mass index(BMI)grade,prostatic hyperplasia(BPH),chronic obstructive pulmonary disease(COPD),hernia classification,unilateral and bilateral,whether emergency surgery,intraoperative treatment of hernia sac and other variables,the propensity score was matched by 1:1 to increase the data comparison.All patients' basic information and perioperative data were prospectively collected and followed up by the hernia treatment center,including operation time,length of stay,and complication information.Result:.The number of patients older than 85 years old was only 4,and the sample size was too small to participate in the comparison.After the matching of propensity score,the influencing factors were controlled.After the matching,they had similar basic information and hernia classification and other clinical characteristics except for age,which made them comparable.A total of 149 pairs were matched between patients aged 45-59 years and patients aged 60-74 years.VAS scores on the postoperative day and the first day were different(P < 0.05),and there were no statistically significant differences in operation time,postoperative hospitalization time and perioperative complications.A total of 59 pairs were matched in patients aged 45-59 years and 75-84 years.VAS scores on the day after surgery and the first day after surgery were different(P < 0.05),and there were no statistically significant differences in postoperative hospital stay and perioperative complications.There were 66 matched inguinal patients aged 60-74,75-84 years.There were no significant differences in operation time,postoperative hospitalization time,VAS score and complications.Conclusion: The effect of TAPP on selected patients aged 60-74 years with inguinal hernia was comparable to that of middle-aged patients during the perioperative period.For selected 75-84 year old patients,the perioperative recovery was smooth,and thepostoperative VAS score of postoperative pain was lower,and no serious complications occurred.Therefore,it has good feasibility and safety,which is worthy of promotion and application.