To compare the efficacy and safety of various surgical techniques for inguinal hernia repair in elderly patients (≥60 years), addressing the uncertainty in current practices.
Key Findings:
Twenty-eight trials involving 3184 patients were included, with a mean or median age of 62–76 years.
Laparoscopic approaches, particularly LR-TEP, showed advantages in perioperative outcomes, including less bleeding (SMD=−15.18) and shorter hospital stays (SMD=−2.30).
Recurrence rates were similar across techniques, except for OMR-Lightweight, which had a higher risk (RR = 26.16).
OMR-PHS demonstrated the best safety profile (RR = 0.04).
LR-TEP and LR-TAPP significantly reduced complications (RR = 0.28 and 0.33, respectively).
IPOM provided the greatest pain relief (SMD=−2.65).
Interpretation:
Minimally invasive repairs, especially LR-TEP, appear to offer favorable short-term recovery outcomes in elderly patients with inguinal hernias, with comparable recurrence rates to open techniques, emphasizing the need for careful patient selection.
Limitations:
The overall risk of bias was low in only 10 trials, with concerns in 8 and high in 10 trials, potentially affecting the reliability of the findings.
Comparative data on various techniques in elderly patients remain limited, highlighting the need for further research.
Conclusion:
Minimally invasive techniques, particularly LR-TEP, may optimize short-term recovery in elderly patients undergoing inguinal hernia repair, underscoring the importance of tailored surgical approaches.
