Mini-mesh and Lichtenstein repair compared with a modified Kugel technique for femoral hernia: a randomised controlled trial

Ann R Coll Surg Engl. 2020 Apr;102(4):284-289. doi: 10.1308/rcsann.2019.0181. Epub 2020 Jan 10.

Abstract

Introduction: A modified Kugel patch is more expensive than ordinary mesh and demands a wide dissection of the preperitoneal space in femoral hernia repair. We therefore adopted a novel method using mini-mesh and a Lichtenstein repair. This study compared mini-mesh and Lichtenstein repair with a modified Kugel technique in patients with a primary unilateral femoral hernia.

Methods: Patients with unilateral femoral hernia were assigned randomly to undergo mini-mesh and Lichtenstein repair (M group) or modified Kugel repair (K group), followed-up at one week, three months, one year and two years. Demographics, hernia characteristics and operative outcomes of two groups were analysed.

Results: A total of 48 patients in the K group and 49 participants in the M group completed follow-up. The operation time for the M group (68.6 ± 13.4 minutes) was significantly shorter than that of the K group (80.6 ± 10.1 minutes; p=0.030). There was no significant difference between the two groups for chronic pain, foreign body feeling and quality of life, and no recurrence occurred.

Conclusions: Mini-mesh and Lichtenstein repairs have reasonable results in the patients with femoral hernia in this study, with a reduced operation time compared with a modified Kugel repair. The trial was registered with the Chinese Clinical Trials Registry: ChiCTR1900022264.

Keywords: Complications; Femoral hernia; Lichtenstein technique; Mini-mesh; Modified Kugel technique.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Hernia, Femoral / surgery*
  • Herniorrhaphy / adverse effects
  • Herniorrhaphy / instrumentation*
  • Herniorrhaphy / methods
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Prospective Studies
  • Quality of Life
  • Recurrence
  • Surgical Mesh*
  • Treatment Outcome