Objective To investigate the clinical effect of local infiltration anesthesia combined with preperitoneal modified Kugel hernia repair on inguinal hernia in elderly female patients. Methods The clinical data of elderly female patients over 60 years old admitted to our hospital from September 2017 to September 2020 were retrospectively analyzed, and patients receiving local anesthesia +modified Kugel repair were selected as study subjects. Postoperative pain, recovery time of non-restricted activity, recurrence of hernia, and complications during follow-up were observed. Results Nineteen patients who met the criteria were followed up, ranging in age from 60 to 81 years old, with an average age of (64.5±3.3) years. Superficial infection of postoperative incision occurred in 1 patient and labia edema occurred in 1 patient. Overall, postoperative pain response was mild and satisfaction was good. The average follow-up time was (13.0±3.0) months. No hernia recurrence was observed, and no chronic pain was found. Conclusion Local infiltration anesthesia combined with preperitoneal modified Kugel hernia repair is an ideal surgical procedure for elderly female inguinal hernia patients who cannot tolerate general anesthesia.
WU Zhen
,
LI Wenlei
,
WANG Yongkun
,
YAO Yumin
,
CUI Zhaoqing
,
ZHANG Yang
,
ZHANG Wei
,
REN Zhongxi
. Clinical application of preperitoneal modified Kugel hernia repair in elderly female patients with inguinal hernia under local infiltration anesthesia[J]. Surgical Research and New Technique, 2022
, 11(3)
: 170
-173
.
DOI: 10.3969/j.issn.2095-378X.2022.03.007
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