To evaluate the safety and effectiveness of open Lichtenstein tension-free hernia repair under local infiltration combined with nerve block anesthesia in patients with peritoneal dialysis (PD)-related inguinal hernia.

Clinical data of 63 patients with peritoneal dialysis-related inguinal hernia who were treated between February 2015 and February 2025 at Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, and its affiliated centers (Yanqing Hospital of Beijing Chinese Medicine Hospital and Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital) were retrospectively analyzed. All patients underwent open Lichtenstein tension-free hernia repair under local infiltration combined with nerve block anesthesia. Demographic characteristics, hernia type, operative indicators, perioperative complications, and follow-up outcomes were collected. Using descriptive statistical methods, continuous variables are presented as median (Q₁,Q₃), and categorical variables as number (%).

All 63 patients successfully completed the procedure. The median age was 64 (60, 67) years, and the median duration of peritoneal dialysis was 33 (17, 50) months. Indirect inguinal hernia was the predominant type (87.3%), and bilateral hernias accounted for 27.0%. The median operative time was 50 (45, 58) minutes, and the median postoperative hospital stay was 1.5 (1.0, 2.0) days. The median Visual Analog Scale (VAS) pain score at 24 hours postoperatively was 2 (1, 2) points. Perioperative dialysis was managed according to a standardized protocol, including temporary cessation of peritoneal dialysis with transition to hemodialysis preoperatively and stepwise resumption of peritoneal dialysis postoperatively after a median of 7 (7,7) days. No dialysate leakage or peritonitis occurred during the perioperative period. Minor complications within 30 days occurred in 6.3% of patients and resolved with conservative management. In the 60 patients who completed the 1-year postoperative follow-up, no hernia recurrence was observed.

For patients with peritoneal dialysis-related inguinal hernia, open Lichtenstein tension-free repair under local anesthesia combined with standardized perioperative dialysis management appears to be safe and feasible. It can achieve low postoperative pain, short hospital stay, and favorable short- to mid-term outcomes. Prospective controlled studies are warranted to further validate these findings and optimize dialysis management strategies.