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Experiences with the Repair of Groin Hernia in 200 Patients Aged 70 or Older *
Author(s) -
PONKA JOSEPH L.,
BRUSH BROCK E.
Publication year - 1974
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1974.tb02154.x
Subject(s) - medicine , groin , surgery , seroma , hernia , inguinal hernia , hernia repair , complication , femoral hernia , local anesthesia , general surgery
A survey was made of the records of 200 patients (158 men and 42 women) aged 70 or older who had undergone repair of groin hernias. In the aged women, femoral hernias were the most common; indirect hernias were seen much less frequently, and there were no direct hernias. In the aged men, large indirect sliding inguinal hernias and simple indirect inguinal hernias were the most common; direct inguinal hernias were seen less frequently than expected. The most serious and easily overlooked complication of hernia, particularly in old women, is bowel strangulation in association with femoral hernia. The operative procedures were individualized and varied. Local anesthesia was used for all poor‐risk patients and was the method of choice in 185 of the 200 patients. A 1% solution of chlorprocaine was the preferred anesthetic agent. The important complications included wound infection in 7 cases and seroma in 7 cases; infection occurred most frequently in association with gangrenous bowel in the hernial sac. As would be expected, urinary‐tract complications were common since nearly half of the men had benign prostatic hypertrophy. One death occurred in the immediate operative period (third postoperative day) from a cerebrovascular accident. Other deaths after postoperative intervals ranging up to fifteen years were caused by concurrent diseases and seemed unrelated to the hernial operation. The postoperative recurrence rate for hernia was 2 per cent. Surgical repair of groin hernia in aged patients can improve the quality of their lives, and in certain cases (e.g., bowel strangulation) can be a life‐saving measure.