Abstract：
Introduction: Bilateral inguinal hernia can be safely repaired simultaneously, open or minimally invasive, in an elective sce-nario. The choice of surgical approach depends on the patient\'s status, hernia characteristics, surgeons and patient preferences. Whether age criteria should be considered when selecting between the two approaches is still a matter of debate. Considering that there is no consensus regarding the best repair in bilateral inguinal herniorrhaphy, the aim of the study is to perform an analysis regarding elective surgical approach of patients with bilateral inguinal hernias. Material and Methods: To study the relationship between exposure to an open versus laparoscopic approach in patients with bilateral inguinal hernia, we conducted a case-control study. In our retrospective analysis, cases (23 patients) were the open-approach hernia repair, and controls (82 patients) were laparoscopic hernia repair. We analyzed two sets of variables: first, related to patient characteristics (age 65 years, BMI 30 kg/m2, smoking habit, HTA status, COPD status, DM status, use of anticoagulants, presence of neoplastic status) and second, variables related to hernia features (inguinoscrotal hernia, recurrent hernia and complicated hernia). Results: The mean age for cases was 73.26 (Ã+-12.99) years and that of controls, was 56.48 (Ã+-15.15) years. Univariate analysis demonstrated four variables with statistical significance: age 65 years, inguinoscrotal hernia, neo-plastic status, and anticoagulant use. When introduced into the multivariate analysis, we noted that only two variables, age 65 years (OR=4.183, 95% CI [1.289, 13.572], p=0.017) and use of anticoagulants (OR=38.876, 95% CI [1.305, 1158.011], p=0.035) reached statistical significance. Conclusion: This study demonstrates that when we refer to bilateral inguinal hernia repair, patients aged 65 years are at risk of having an open procedure at least fourfold more than patients aged 65 years. In addition, the use of anticoagulants increases the risk of open hernia repair 38 times more than that of minimally invasive repair for the same age group. Interestingly, in our study, hernia characteristics were not found to be associated with open hernia repair and age 65 years. In our study we found that age 65 years is associated with electing open hernia repair over minimally invasive repair, which can be linked to age-related risk factors. Further re-search is needed to investigate the impact of age and age-related risk factors on surgical outcomes of bilateral inguinal hernia repair.
摘要：
简介：双侧腹股沟疝可以同时安全修复，开放或微创，选修sce-nario.手术方式的选择取决于病人的状态,疝的特点，外科医生和患者偏好。在两种方法之间进行选择时是否应考虑年龄标准仍然是一个争论的问题。考虑到对双侧腹股沟疝修补术的最佳修复尚无共识，本研究的目的是对双侧腹股沟疝患者的择期手术方法进行分析。材料和方法：研究双侧腹股沟疝患者的开放与腹腔镜暴露之间的关系，我们进行了一项病例对照研究.在我们的回顾性分析中，病例（23例）为开放入路疝修补术，对照组（82例）为腹腔镜疝修补术。我们分析了两组变量:第一,与患者特征相关(年龄65岁，BMI30kg/m2，吸烟习惯，HTA状态,COPD状态，DM状态,使用抗凝剂，肿瘤状态的存在)和第二，与疝特征相关的变量(腹股沟腹疝，复发性疝和复杂性疝）。结果：病例的平均年龄为73.26（±12.99）岁，对照组为，是56.48（±15.15）年。单变量分析表明四个变量具有统计学意义：年龄65岁，腹股沟阴囊疝,新塑料的地位，和抗凝剂的使用。当引入多变量分析时，我们注意到只有两个变量，年龄65岁（OR=4.183，95%CI[1.289，13.572]，p=0.017)和抗凝剂的使用(OR=38.876,95%CI[1.305,1158.011],p=0.035)达到统计学意义。结论：这项研究表明，当我们提到双侧腹股沟疝修补术时，65岁患者接受开放手术的风险至少是65岁患者的4倍.此外,对于同一年龄组，使用抗凝剂增加开放式疝修补术的风险是微创修补术的38倍。有趣的是,在我们的研究中,未发现疝特征与开放式疝修补术和年龄65岁相关.在我们的研究中，我们发现年龄65岁与选择开放式疝修补术而不是微创修补术有关，这可能与年龄相关的风险因素有关。需要进一步研究年龄和年龄相关危险因素对双侧腹股沟疝修补术疗效的影响。
