To evaluate the safety and feasibility of inguinal hernia repair surgery in patients over 70 years old under day surgery mode.

Clinical data of patients who underwent inguinal hernia repair surgery in the Department of Gastrointestinal Hernia Surgery of Nanchong Central Hospital from January 2021 to December 2023 was retrospectively collected. According to the different admission methods and ages of patients, they were divided into three groups: ≥70 years old day surgery group, ≥70 years old hospitalization surgery group, and <70 years old day surgery group. Propensity score matching (PSM) method was used to match the ≥70 years old day surgery group with the ≥70 years old hospitalization surgery group, and the ≥70 years old day surgery group with the <70 year old day surgery group pairwise. The clinical indicators of postoperative recovery period between the two groups of patients after matching were compared respectively.

In this study, 219 patients ≥70 years old who underwent day surgery, 612 patients ≥70 years old who underwent ordinary in-patient surgery, and 531 patients <70 years old who underwent day surgery were included. Through a 1:1 PSM, 208 patients were included in the ≥70 years old day surgery group and the ≥70 years old hospitalization surgery group as a comparative study. There was no significant difference between the two groups in bleeding, operation time, postoperative fever, nausea, vomiting, urinary retention, venous thromboembolism (VTE), seroma, wound healing, discharge visual analogue scale (VAS) pain score, and recurrence (P>0.05). However, in the comparison of hospitalization costs between the two groups of patients[≥70 years old day surgery group (12 949.88±3439.28) yuan, ≥70 years old hospitalization surgery group (15 070.09±3090.63) yuan, P<0.001], the hospitalization surgery group had higher costs than the day surgery group, and the difference was statistically significant (P<0.05). Similarly, after a 1:1 PSM, 152 patients were included in the day surgery group ≥70 years old and the day surgery group <70 years old as a comparative study. There was no significant difference between the two groups in bleeding, operation time, hospital costs, postoperative fever, nausea, vomiting, urinary retention, VTE, seroma, incision healing, discharge VAS pain, and recurrence (P>0.05).

This retrospective study based on PSM showed that elderly patients over 70 years old who have good anesthesia risk assessment (as required by the guidelines for inguinal hernia day surgery), have underlying diseases, and do not require complex multidisciplinary cooperation for diagnosis and treatment, are safe and feasible to undergo hernia day surgery.