Optimal surgical and anesthetic approaches for inguinal hernia repair in octogenarians and nonagenarians: a multicenter cohort study in Japan
- 01.12.2025
- Original Article
Erschienen in:
- Verfasst von
- Ryosuke Mizuno
- Shusaku Honma
- Kazuki Nishida
- Tomonori Morimoto
- Yuta Iwasaki
- Yudai Sasaki
- Akira Shimada
- Yusuke Mishima
- Keisuke Tanino
- Ryo Ataka
- Yuma Tanigawa
- Yuta Nishikawa
- Takahiro Suenaga
- Takuma Kawarabayashi
- Keita Hanada
- Shotaro Matsuda
- Takayuki Kawai
- Kaede Hirayama
- Masaaki Moriyama
- Kento Masuda
- Keiji Nagata
- Kazutaka Obama
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Purpose
We aimed to develop treatment strategies for older patients with inguinal hernia considering adequate adjustment for operative risks and a comparison that accounts for differences in surgical and anesthetic approaches.
Methods
This retrospective cohort study included 1935 patients aged ≥ 80 years diagnosed with inguinal hernia at 21 facilities in Japan between January 2019 and December 2023. We compared surgical approaches performed under general anesthesia and separately analyzed anesthetic approaches in patients who underwent open surgery. Analysis was conducted using the inverse probability of treatment weighting method to adjust for confounding factors.
Results
Of the 1935 patients, 841 underwent laparoscopic surgery (LS), while 1094 underwent open surgery (OS) with general anesthesia (GA) in 373, spinal anesthesia (SA) in 401, and local anesthesia (LA) in 320. Overall postoperative complication rates of Clavien–Dindo Grade II or higher were comparable between surgical approaches under GA (LS: 3.8% vs. OS: 3.4%; risk ratio [RR]: 1.10; 95% confidence interval [CI]: 0.57, 2.10). Comparisons of anesthetic approaches among patients with OS showed that complication rates were lower in the LA group ([LA: 1.5% vs. GA: 3.5%; RR: 0.43; 95% CI: 0.13, 1.42] and [LA: 1.1% vs. SA: 3.6%; RR: 0.29; 95% CI: 0.10, 0.90]). The LS group had a lower incidence of chronic pain than that in the OS group (LS: 1.7% vs. OS: 3.2%; RR: 0.53; 95% CI: 0.21, 1.30).
Conclusion
Laparoscopic inguinal hernia repair is a feasible option for octogenarians and nonagenarians. When general anesthesia is avoided, open surgery using local anesthesia is preferred.
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- Titel
- Optimal surgical and anesthetic approaches for inguinal hernia repair in octogenarians and nonagenarians: a multicenter cohort study in Japan
- Verfasst von
-
Ryosuke Mizuno
Shusaku Honma
Kazuki Nishida
Tomonori Morimoto
Yuta Iwasaki
Yudai Sasaki
Akira Shimada
Yusuke Mishima
Keisuke Tanino
Ryo Ataka
Yuma Tanigawa
Yuta Nishikawa
Takahiro Suenaga
Takuma Kawarabayashi
Keita Hanada
Shotaro Matsuda
Takayuki Kawai
Kaede Hirayama
Masaaki Moriyama
Kento Masuda
Keiji Nagata
Kazutaka Obama
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03338-3
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