Application and Prognosis of Modified Direct Incision Preperitoneal Repair in the Treatment of Incarcerated Femoral Hernia in Elderly Women

ZHU Guihua; CHEN Fei; WU Fengchun; QIU Zhiqiang; HU Zhonghua

doi:10.14033/j.cnki.cfmr.2024.36.017

Abstract：Objective:To investigate the application and prognosis of modified direct incision preperitoneal repair in the treatment of incarcerated femoral hernia in elderly women.Method:One hundred elderly female patients with incarcerated femoral hernia admitted to Nantong Tongzhou Hospital of Traditional Chinese Medicine from January 2020 to January 2024 were selected as the study objects and randomly divided into the observation group(modified direct incision preperitoneal repair group,n=50)and the control group(traditional open repair group,n=50).The surgical duration,intraoperative blood loss,postoperative pain score[visual analogue scale(VAS)],time to first flatus,duration of negative pressure drainage,length of hospital stay,incidence of postoperative complications(postoperative infection,hernia recurrence,urinary retention,chronic pain,etc.),postoperative inflammatory response(C-reactive protein level and white blood cell count at 24 hours postoperatively),levels of biomarkers[interleukin-6(IL-60)and tumor necrosis factor-α(TNF-α)at 24 hours postoperatively],psychological health status[hospital anxiety and depression scale(HADS)]at 1 month postoperatively,and Barthel index at 1 and 3 months postoperatively were compared between the two groups.Result:The 24-hour postoperative Visual Analog Scale(VAS)pain scores in the observation group were significantly lower than those in the control group,with a statistically significant difference(P<0.05).In terms of postoperative recovery,the observation group had significantly shorter times for first flatus,indwelling time of negative pressure drainage tube,and hospital stay compared to the control group,with statistically significant differences(P<0.05).The incidence of complications in the observation group was significantly lower than in the control group(P<0.05).The levels of C-reactive protein and white blood cell count 24 hours postoperatively in the observation group were significantly lower those than in the control group,with statistically significant differences(P<0.05).The levels of IL-6 and TNF-α 24 hours postoperatively in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).One month postoperatively,the HADS scores in the observation group were significantly higher than those in the control group,with a statistically significant difference(P<0.05).Additionally,the Barthel index at one month and three months postoperatively in the observation group were significantly higher than those in the control group,with statistically significant differences(P<0.05).Conclusion:The modified direct incision preperitoneal repair has a good application effect in the treatment of incarcerated femoral hernia in elderly women,which can effectively reduce postoperative pain,shorten recovery time,reduce the incidence of complications,and improve psychological health and rehabilitation quality.