Age as a non-contraindication for surgical intervention in patients with abdominal wall incisional hernia: an exploration and analysis.

Abstract

Background: Surgery is the only potential curative option in patients presenting with abdominal wall incisional hernia (IH). The approach clearly enhances patients' quality of life and reduces complications, however, the management of patients over 60 years old presents significant challenges, primarily due to the comorbidities and the complexities associated with postoperative recovery. The objective of this study was to examine postoperative outcomes in the age group over 60 years and the age group under 60 years.

Methods: The study included a retrospective analysis of all patients who underwent surgical treatment for IH between December 2018 and March 2023. The patient cohort was divided into two age groups: <60 years old and ≥ 60 years old. A comparison was made between the two groups in terms of baseline and intraoperative characteristics, as well as postoperative complications and recurrence.

Results: During the study period, a total of 304 patients were enrolled, with 86 (28.3%) in the < 60 years age group and 218 (71.7%) in the ≥ 60 years age group. Baseline characteristics were comparable between the two groups, except for a higher prevalence of high blood pressure and ASA score among older patients. The intraoperative characteristics did not show any statistically significant differences between the two groups. In the < 60 age group, the incidence of postoperative intestinal fistula and the 1-year recurrence rate were both zero, indicating a complete absence of these complications. Apart from the duration of hospitalization, there was no statistically significant difference in postoperative outcomes between the two age groups. Notably, patients aged ≥ 60 years experienced a longer length of hospital stay (p = 0.009).

Conclusion: The postoperative complications and recurrence rate of patients with IH appear to be independent of age, thus advocating for surgical intervention regardless of the patient's age whenever feasible.