Laparoscopic vs. open inguinal hernia repair outcomes in patients aged 65 years and older

作者：Abdulkarem Al-Sharabi, Yang Xu, Abdullah Al-Danakh, ZhaoHui Xu, A. Alsharabi, HaoNan Kang, GuoYi Wen, Yan Shan, BoXin Qu, Shuai Shao, YanYing Ren, J.H. Lee, Fan Zhang, Xin Chen · 发表于：Frontiers in Surgery · 年份：2025 · DOI：10.3389/fsurg.2025.1610358 · 被引用次数：5 · 研究领域：Hernia repair and management、Aortic aneurysm repair treatments、Congenital Diaphragmatic Hernia Studies

Background Inguinal hernia affects approximately 27% of men and 3% of women, with prevalence rising markedly after age 65 due to weakened abdominal walls and comorbidities such as chronic obstructive pulmonary disease and benign prostatic hyperplasia, which increase intra-abdominal pressure. Standard treatment involves surgical repair using either open or laparoscopic techniques. However, the optimal approach for elderly patients remains debated due to higher comorbidity rates and unique physiological considerations. This study compares outcomes of laparoscopic and open inguinal hernia repair in patients aged ≥65 years to support evidence-based surgical decision-making. Methods We conducted a retrospective analysis of 384 patients aged ≥65 years who underwent inguinal hernia repair at the Second Affiliated Hospital of Dalian Medical University between 2020 and 2022. Patients were classified into laparoscopic ( n = 197) and open ( n = 187) repair groups. Demographics, operative details, and postoperative outcomes were compared using chi-square tests, Mann–Whitney U tests, and multivariable logistic regression (SPSS v27), with statistical significance set at p < 0.05. Results The laparoscopic cohort was younger [median 70 (65–91) vs. 75 (65–98) years; p < 0.001], had a higher prevalence of bilateral hernias (25.9% vs. 4.3%; p < 0.001), and smaller hernia sacs [2.50 (1–5) cm vs. 3 (1–5) cm; p < 0.001]. Although operative time was longer for laparoscop...