Abstract:

Laparoscopic inguinal hernia repair in elderly patients              LI Jian-wen, YUE Fei. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Minimally Invasive Surgery Center, Shanghai 200025, China
Corresponding author：LI Jian-wen，E-mail：ljw5@yeah.net
Abstract    The elective inguinal hernia repair is recommended for elderly patients. The preperitoneal repair is a rational operation due to the weakness of transversalis fascia. Laparoscopic preperitoneal repair, including transabdominal preperitoneal prosthetic (TAPP) and totally extraperitoneal prosthetic (TEP), are safe procedures for elderly patients with ASA score 1-2. The therapeutic effects of laparoscopic inguinal hernia repair are similar between elderly and general population. The rates of postoperative urinary retention and seroma might increase slightly, but laparoscopic procedure has the tendency to achieve better results in chronic pain, comfort and satisfaction. The pathophysiological effects of pre-pneumoperitoneum should be taken into consideration, when TEP is selected for octogenerians.

Key words: elderly, inguinal hernia, laparoscope, hernia repair

摘要：

老年腹股沟疝病人建议择期手术治疗。老年病人腹横筋膜松弛薄弱，腹膜前修补术是合理的选择。经腹腔腹膜前疝修补术（TAPP）和完全腹膜外疝修补术（TEP）是应用腹腔镜技术进行腹膜前修补，对于美国麻醉医师协会（ASA）分级1～2级的老年病人安全可行。老年病人行腹腔镜腹股沟疝修补术的疗效与总群体相似，术后在轻微并发症方面略有差异，如尿潴留比例升高、血清肿比例可能升高等；在慢性疼痛、舒适度评分、满意度等方面可能略有优势。高龄老年病人（＞80岁）在选择TEP时需考虑腹膜外CO2气腹对病理生理的影响。

关键词: 老年, 腹股沟疝, 腹腔镜, 疝修补术