Postoperative outcomes after inguinal hernia repair in octogenarians in Germany: an exploratory analysis of a retrospective single-centre cohort.

BACKGROUND: As the population ages, the number of elderly patients undergoing inguinal hernia repair is increasing. Advanced age is associated with higher rates of comorbidity and frailty, which may potentially affect postoperative outcomes. This study evaluated postoperative morbidity in different age groups with a focus on octogenarians. METHODS: This exploratory retrospective single-centre study included 388 patients undergoing elective inguinal hernia repair between 2014 and 2020. The patients were stratified into three groups according to age < 65 years (n = 240), 65-79 years (n = 117), and ≥ 80 years (n = 31). Open (Lichtenstein) and transabdominal preperitoneal laparoscopic techniques were analysed. The primary outcome was postoperative morbidity according to the Clavien-Dindo classification. Logistic regression analyses were performed to identify risk factors. RESULTS: Octogenarians more frequently underwent open repair, whereas younger patients more often received laparoscopic treatment (p < 0.001). No significant differences were observed between age groups in regard to intraoperative or overall postoperative complications, including complication severity. In the multivariable analysis, age was not associated with postoperative complications (p = 0.974). Laparoscopic repair was associated with lower odds of postoperative complications (odds ratio (OR) 0.544; p = 0.031), while longer operative time was associated with increased risk of complications (OR 1.009; p = 0.022). CONCLUSIONS: Octogenarians did not show increased postoperative morbidity. Surgical decision-making should not rely on chronological age alone. TRIAL REGISTRATION: Not applicable.