A prospectively randomized controlled study between mini-mesh and modified Kugel patch in femoral hernia repair_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANG Dianchen , ZHANG Yi , CHEN Jianmin , CHEN Yake

Department of Hernia and Abdominal Wall Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, P. R. China;

Corresponding author：

WANG Dianchen, Email: wdc8681949@163.com

Keywords：

femoral hernia; modified Kugel patch; mini-mesh; complication

DOI：

10.7507/1007-9424.201906002

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the outcomes after mini-mesh approach to modified Kugel technique in femoral hernia repair.Methods The clinical data of 99 patients with primary unilateral femoral hernia who were admitted to The First Affiliated Hospital of Zhengzhou University from July 2012 to December 2016 were prospectively analyzed. A randomized controlled study was performed based on a random number table. All patients were allocated into mini-mesh group and Kugel group. The outcomes including operative time, wound pain scores (1 week after operation), analgesic used, hospital stay after operation, urinary retention, wound infection, seroma, and femoral vein thrombosis were recorded. Patients were followed-up at 3 months, 1 year, and 2 years after operation. Follow-up data included chronic pain, foreign body feeling, quality of life, and recurrence.Results Ninety-seven patients completed follow-up. There were 48 patients in the Kugel group and 49 patients in the mini-mesh group. The operation time of the mini-mesh group was significantly shorter than that of the Kugel group (P=0.030). There was no significant difference in analgesic used, hospital stay after operation, urinary retention, visual analog scale of wound pain at rest (VAS) 1 week postoperatively, and VAS of wound pain on coughing 1 week postoperatively between the two groups (P>0.05). No patient had wound infection, seroma or femoral vein thrombosis in the two groups. At 3 months, 1 year, and 2 years follow-up, there was no significant difference in chronic pain, foreign body feeling, and SF-36 score between the two groups (P>0.05). Ninety-seven patients completed 2 years follow-up, with no recurrence occurred during follow-up period.Conclusions The operative outcomes of mini-mesh repair are comparable to modified Kugel repair with a reduced operation time in femoral hernia patients. It is a safe and promising technique.

Citation： WANG Dianchen, ZHANG Yi, CHEN Jianmin, CHEN Yake. A prospectively randomized controlled study between mini-mesh and modified Kugel patch in femoral hernia repair. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(9): 1056-1060. doi: 10.7507/1007-9424.201906002 Copy

1.	Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet, 2003, 362(9395): 1561-1571.
2.	Wang D, Chen J, Chen Y, et al. Prospective analysis of epigastric, umbilical, and small incisional hernia repair using the modified kugel oval patch. Am Surg, 2018, 84(2): 305-308.
3.	Read RC. Recent advances in the repair of groin herniation. Curr Probl Surg, 2003, 40(1): 13-79.
4.	Gallegos NC, Dawson J, Jarvis M, et al. Risk of strangulation in groin hernias. Br J Surg, 1991, 78(10): 1171-1173.
5.	Song Y, Lu A, Ma D, et al. Long-term results of femoral hernia repair with ULTRAPRO Plug. J Surg Res, 2015, 194(2): 383-387.
6.	Kugel RD. The Kugel repair for groin hernias. Surg Clin North Am, 2003, 83(5): 1119-1139.
7.	Zandi G, Vasquez G, Buonanno A, et al. PHS repair in femoral hernia surgery. Minerva Chir, 2003, 58(6): 797-799.
8.	Hernandez-Richter T, Schardey HM, Rau HG, et al. The femoral hernia: an ideal approach for the transabdominal preperitoneal technique (TAPP). Surg Endosc, 2000, 14(8): 736-740.
9.	Yalamarthi S, Kumar S, Stapleton E, et al. Laparoscopic totally extraperitoneal mesh repair for femoral hernia. J Laparoendosc Adv Surg Tech A, 2004, 14(6): 358-361.
10.	Yau KK, Siu WT, Cheung YS, et al. Laparoscopic management of acutely incarcerated femoral hernia. J Laparoendosc Adv Surg Tech A, 2007, 17(6): 759-762.
11.	Li J, Zhang Y, Hu H, et al. Early experience of performing a modified Kugel hernia repair with local anesthesia. Surg Today, 2008, 38(7): 603-608.
12.	洪楠, 陈健民, 王殿琛, 等. 聚丙烯小平片修补股疝56例. 中华疝和腹壁外科杂志: 电子版, 2014, 8(1): 28-29.
13.	中华医学会外科学分会疝和腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊疗指南 (2014年版). 中华外科杂志, 2014, 52(7): 481-484.
14.	赵爽, 黄子星, 刘荣波, 等. 腹股沟疝和股疝的多排螺旋CT鉴别诊断. 中国普外基础与临床杂志, 2013, 20(12): 1424-1427.
15.	Rönkä K, Vironen J, Kössi J, et al. Randomized multicenter trial comparing glue fixation, self-gripping mesh, and suture fixation of mesh in Lichtenstein hernia repair (FinnMesh Study). Ann Surg, 2015, 262(5): 714-719.
16.	Sandblom G, Haapaniemi S, Nilsson E. Femoral hernias: a register analysis of 588 repairs. Hernia, 1999, 3(3): 131-134.
17.	Büchin P, Steinau G, Ophoff K, et al. Femoral hernia in childhood: evaluation of sonography as a diagnostic aid. Hernia, 1999, 3(1): 19-21.
18.	段华山. 股疝 38 例临床分析. 中国普外基础与临床杂志, 2010, 17(4): 397-398.
19.	Sorelli PG, El-Masry NS, Garrett WV. Open femoral hernia repair: one skin incision for all. World J Emerg Surg, 2009, 4: 44.
20.	Ceriani V, Faleschini E, Sarli D, et al. Femoral hernia repair. Kugel retroparietal approach versus plug alloplasty: a prospective study. Hernia, 2006, 10(2): 169-174.
21.	Chen J, Lv Y, Shen Y, et al. A prospective comparison of preperitoneal tension-free open herniorrhaphy with mesh plug herniorrhaphy for the treatment of femoral hernias. Surgery, 2010, 148(5): 976-981.
22.	Nikolova S, Harrison M, Sutton M. The impact of waiting time on health gains from surgery: evidence from a National Patient-reported Outcome Dataset. Health Econ, 2016, 25(8): 955-968.
23.	Kulacoglu H. Mini-mesh repair for femoral hernia. Int J Surg Case Rep, 2014, 5(9): 574-576.
24.	Garg P, Ismail M. Laparoscopic total extraperitoneal repair in femoral hernia without fixation of the mesh. JSLS, 2009, 13(4): 597-600.
25.	Sajid MS, Kalra L, Parampalli U, et al. A systematic review and meta-analysis evaluating the effectiveness of lightweight mesh against heavyweight mesh in influencing the incidence of chronic groin pain following laparoscopic inguinal hernia repair. Am J Surg, 2013, 205(6): 726-736.
26.	de Goede B, Klitsie PJ, van Kempen BJ, et al. Meta-analysis of glue versus sutured mesh fixation for Lichtenstein inguinal hernia repair. Br J Surg, 2013, 100(6): 735-742.
27.	Kolbe T, Hollinsky C, Walter I, et al. Influence of a new self-gripping hernia mesh on male fertility in a rat model. Surg Endosc, 2010, 24(2): 455-461.

1. Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet, 2003, 362(9395): 1561-1571.
2. Wang D, Chen J, Chen Y, et al. Prospective analysis of epigastric, umbilical, and small incisional hernia repair using the modified kugel oval patch. Am Surg, 2018, 84(2): 305-308.
3. Read RC. Recent advances in the repair of groin herniation. Curr Probl Surg, 2003, 40(1): 13-79.
4. Gallegos NC, Dawson J, Jarvis M, et al. Risk of strangulation in groin hernias. Br J Surg, 1991, 78(10): 1171-1173.
5. Song Y, Lu A, Ma D, et al. Long-term results of femoral hernia repair with ULTRAPRO Plug. J Surg Res, 2015, 194(2): 383-387.
6. Kugel RD. The Kugel repair for groin hernias. Surg Clin North Am, 2003, 83(5): 1119-1139.
7. Zandi G, Vasquez G, Buonanno A, et al. PHS repair in femoral hernia surgery. Minerva Chir, 2003, 58(6): 797-799.
8. Hernandez-Richter T, Schardey HM, Rau HG, et al. The femoral hernia: an ideal approach for the transabdominal preperitoneal technique (TAPP). Surg Endosc, 2000, 14(8): 736-740.
9. Yalamarthi S, Kumar S, Stapleton E, et al. Laparoscopic totally extraperitoneal mesh repair for femoral hernia. J Laparoendosc Adv Surg Tech A, 2004, 14(6): 358-361.
10. Yau KK, Siu WT, Cheung YS, et al. Laparoscopic management of acutely incarcerated femoral hernia. J Laparoendosc Adv Surg Tech A, 2007, 17(6): 759-762.
11. Li J, Zhang Y, Hu H, et al. Early experience of performing a modified Kugel hernia repair with local anesthesia. Surg Today, 2008, 38(7): 603-608.
12. 洪楠, 陈健民, 王殿琛, 等. 聚丙烯小平片修补股疝56例. 中华疝和腹壁外科杂志: 电子版, 2014, 8(1): 28-29.
13. 中华医学会外科学分会疝和腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊疗指南 (2014年版). 中华外科杂志, 2014, 52(7): 481-484.
14. 赵爽, 黄子星, 刘荣波, 等. 腹股沟疝和股疝的多排螺旋CT鉴别诊断. 中国普外基础与临床杂志, 2013, 20(12): 1424-1427.
15. Rönkä K, Vironen J, Kössi J, et al. Randomized multicenter trial comparing glue fixation, self-gripping mesh, and suture fixation of mesh in Lichtenstein hernia repair (FinnMesh Study). Ann Surg, 2015, 262(5): 714-719.
16. Sandblom G, Haapaniemi S, Nilsson E. Femoral hernias: a register analysis of 588 repairs. Hernia, 1999, 3(3): 131-134.
17. Büchin P, Steinau G, Ophoff K, et al. Femoral hernia in childhood: evaluation of sonography as a diagnostic aid. Hernia, 1999, 3(1): 19-21.
18. 段华山. 股疝 38 例临床分析. 中国普外基础与临床杂志, 2010, 17(4): 397-398.
19. Sorelli PG, El-Masry NS, Garrett WV. Open femoral hernia repair: one skin incision for all. World J Emerg Surg, 2009, 4: 44.
20. Ceriani V, Faleschini E, Sarli D, et al. Femoral hernia repair. Kugel retroparietal approach versus plug alloplasty: a prospective study. Hernia, 2006, 10(2): 169-174.
21. Chen J, Lv Y, Shen Y, et al. A prospective comparison of preperitoneal tension-free open herniorrhaphy with mesh plug herniorrhaphy for the treatment of femoral hernias. Surgery, 2010, 148(5): 976-981.
22. Nikolova S, Harrison M, Sutton M. The impact of waiting time on health gains from surgery: evidence from a National Patient-reported Outcome Dataset. Health Econ, 2016, 25(8): 955-968.
23. Kulacoglu H. Mini-mesh repair for femoral hernia. Int J Surg Case Rep, 2014, 5(9): 574-576.
24. Garg P, Ismail M. Laparoscopic total extraperitoneal repair in femoral hernia without fixation of the mesh. JSLS, 2009, 13(4): 597-600.
25. Sajid MS, Kalra L, Parampalli U, et al. A systematic review and meta-analysis evaluating the effectiveness of lightweight mesh against heavyweight mesh in influencing the incidence of chronic groin pain following laparoscopic inguinal hernia repair. Am J Surg, 2013, 205(6): 726-736.
26. de Goede B, Klitsie PJ, van Kempen BJ, et al. Meta-analysis of glue versus sutured mesh fixation for Lichtenstein inguinal hernia repair. Br J Surg, 2013, 100(6): 735-742.
27. Kolbe T, Hollinsky C, Walter I, et al. Influence of a new self-gripping hernia mesh on male fertility in a rat model. Surg Endosc, 2010, 24(2): 455-461.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

A prospectively randomized controlled study between mini-mesh and modified Kugel patch in femoral hernia repair

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content