To analyze the safety of performing Lichtenstein repair under local anesthesia in an ambulatory (day-case) surgery setting for patients with inguinal hernia who are on a single antiplatelet medication.

A retrospective analysis was conducted on 1986 patients who underwent day-case Lichtenstein repair under local anesthesia for inguinal hernia at Beijing Chaoyang Hospital, Capital Medical University, between January 2023 and June 2025. Patients were divided into an observation group (178 cases) receiving a single antiplatelet agent (aspirin or clopidogrel) and a control group (1808 cases) not on such medication. The two groups were compared regarding general patient data, hernia type, operative time, time to ambulation, postoperative pain scores, and the incidence of complications (including hematoma, seroma, wound infection, inguinal region pain, recurrence, and deep vein thrombosis) at follow-up visits of 1 week, 1 month, and 3 months postoperatively.

There were no statistically significant differences between the two groups in baseline characteristics such as gender, age, body mass index, operative time, and length of hospital stay(P>0.05). Furthermore, at all follow-up time points (1 week, 1 month, 3 months), no statistically significant differences were observed in the incidence of complications including incision infection, seroma, surgical site hematoma, inguinal region pain, recurrence, and deep vein thrombosis between the observation group and the control group (P>0.05).

For patients with inguinal hernia on a single antiplatelet agent (aspirin or clopidogrel), performing Lichtenstein repair under local anesthesia in strictly managed medical centers with established ambulatory admission protocols is safe and feasible. This approach does not significantly increase the risk of perioperative or short-term postoperative complications.