关键词: 老年, 腹股沟疝, 围手术期管理, 指南, 共识

Abstract:

Diagnosis and treatment of elderly inguinal hernia ——Recommendations and blanks in relevant guidlines (or consensus)        LI Hang-yu. Department of Hernia and Abdominal Wall Surgery, the Fourth Hospital Of China Medical University,Shenyang 10032,China
Abstract    According to the recommendations of the relevant domestic and foreign authoritative guidlines (or consensus) literature on the perioperative management for elderly patients, combined with the experience in clinical work of inguinal hernia, the perioperative period of the elderly inguinal hernia needs to pay attention to 11 problems, including the preoperative assessment of the basic state, the timing of surgery, the routine examination, antibiotic prophylaxis,the selection of surgical methods, the choice of anesthesia, the management of ambulatory surgery and the postoperative urine retention, thrombosis, and delirium prevention and management. Referring to the guidelines for the diagnosis and treatment of adult inguinal hernia, there are 4 aspact of hot issues about the elderly inguinal hernia worth concerning:  The timing of surgery for an elderly inguinal hernia, the choice of anesthesia and surgical methods, the prevention and management of complications, and how to analyze and interpret this hot topic based on age stratification.The guidlines(or consensus) give detailed advice on some issues, some of which only give a general description, while some are blank and no clear guidance is given. The author recommended that the elderly patients with inguinal hernia be managed according to age, and the preoperative basic state assessment should be performed. Surgical treatment should be performed as soon as possible, and the plain patch before the local anesthesia should be recommended.

Key words: elderly, inguinal hernia, perioperative management, guidline, consensus