Outcomes of Emergency Groin Hernia Repair in the Elderly: A Systematic Review.

Autor:	Piltcher-da-Silva R; General Surgery Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil., Sasaki VL; General Surgery Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil., Bettini LFC; General Surgery Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil., Soares PSM; Postgraduate Epidemiology Department, Universidade Federal de Pelotas, Pelotas, Brazil., Valandro IG; General Surgery Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil., Cavazzola LT; General Surgery Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of abdominal wall surgery : JAWS [J Abdom Wall Surg] 2023 Jun 13; Vol. 2, pp. 11246. Date of Electronic Publication: 2023 Jun 13 (Print Publication: 2023).
DOI:	10.3389/jaws.2023.11246
Abstrakt:	Introduction: The number of surgeries for groin hernia (GH) among the elderly follows the increase in life expectancy of the population. The greater number and severity of comorbidities in this group increases the surgical risk, promoting discussion regarding the indication of elective surgery and the benefits of watchful waiting approach (WWA). The aim of the present study was to evaluate the outcomes of emergency hernia surgery among the elderly population. Materials and methods: A systematic review was performed in Pubmed and Scielo databases for the past early 10 years, until July 2022. The subject was groin hernia in the emergency setting focusing the elderly population. The PRISMA statement was followed and the classification of elderly was based on the World Health Organization's definition. Results: A total of 1,037 results were returned and we ended with nine original articles with emphasis in groin hernia in the emergency among the elderly population. In these subjects, the complications rate ranged between 21.2% and 28.9% and the mortality rate ranged between 1.2% and 6%. Cardiopulmonary disease, high ASA and Charlson's scales were associated with greater risk of complications and death. Conclusion: Emergency GH surgery in the elderly population carries an increased risk of complications and mortality. GH surgery is safe or, at least, less harmful when done electively. The risk and benefits of WWA and upfront surgery needs to be assessed and exposed to the patients. Our review sugest that elective surgery should be the option over WWA in this patient population. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Piltcher-da-Silva, Sasaki, Bettini, Soares, Valandro and Cavazzola.)
Databáze:	MEDLINE
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