The Comparison Of Elective Repair Versus Emergency Surgery In The Elderly Patients With Ventral Hernia

Objective: With the increase in life span and expectancy, elderly patients are more frequently encountered. Advanced technology and medical applications enabled the elderly patients to be operated more easily and reduced their morbidity and mortality risks at the same rate. We aimed to evaluate the elderly patients who were treated electively and emergently due to ventral hernia and to compare the outcomes of their treatments in this study. Material and Method: The files of the elderly patients who were diagnosed with ventral hernia in our clinic between January-2012 and November-2014 were screened retrospectively. Thirty-eight patients aged 65 years and over were divided into two groups as emergently (Group-I) or electively (Group-II) operated patients. They were compared in terms of comorbid diseases (cardiac, pulmonary, endocrine and other) and complications (seroma, wound infection, ileus and others). Results: Ten (26%) patients were determined as emergency (Group-I) and 28 patients(74%) as elective surgery group (Group-II).No statistically significant difference was found between two groups in terms of ASA values (p = 0.27). Of 31 patients (78%) with comorbid disease, eight (24%) were in Group-I and 23 (76%) were observed to be in Group-II (p = 0.60). Of five patients (13.1%) who required intensive care need, four (10.5%) were in Group- I and one (2.6%) was in Group-II (p=0.012). Complication developed in nine patients (23.6%) and three of them (7.9%) were classified as Group-I and six of them (15.7%) as Group-II (p = 0.44). Seroma was found in three patients (7.9%) and one of them (2.6%) was in Group-I and two patients (5.2%) were in Group-II (p = 0.61). Conclusion: Our study suggests that, in the future, non-operative observation may be preferred compared to emergency or elective surgical procedures for the elderly cases with asymptomatic incisional hernia