E. Ohlrogge1, K. O’Connell1, T. Webb1 1Medical College Of Wisconsin,Trauma/Critical Care,Milwaukee, WI, USA
Introduction: The aging population is on the rise in the United States, and general surgeons are increasingly operating on geriatric patients for repair of ventral hernias. This study investigates the risk factors associated with complications following both laparoscopic and open ventral hernia repairs in elderly patients. Specifically, we were interested if frailty markers predicted poorer outcomes.
Methods: This is a retrospective review of patients 65 years and older who underwent ventral hernia repair at a single institution from July 1 2004 to June 1, 2014. Patient demographics, comorbidities, frailty markers, and perioperative factors were analyzed.
Results:The cohort consisted of seventy-three patients, of which 32 (43%) were performed laparoscopically and 41 (56%) were open ventral hernia repairs. 8 (11%) were emergent cases, and only 2 (25%) of these were completed laparoscopically. Overall, 23 (31%) patients developed post-operative complications, 11 (47%) following laparoscopic repairs and 12 (52%) following open repairs. The most common complications were urinary tract infections, wound complications, and early post-operative small bowel obstructions. Frailty markers were not associated with post operative complications; however, a history of heart disease (p=0.04), obesity (p=0.04), and prior percutaneous coronary intervention PCI (p=0.05) did predict complications. There were no deaths in the post-operative period.
Conclusion:This study suggests that laparoscopic ventral hernia repair in elderly patients is at least as safe as the traditional open approach and complications are common with either approach. Furthermore, history of heart disease, obesity, and PCI, but not currently used frailty markers predispose aging patients to post-operative complications following either laparoscopic or open ventral hernia repair.