ObjectiveTo compare the outcomes after mini-mesh approach to modified Kugel technique in femoral hernia repair.MethodsThe 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.ResultsNinety-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.ConclusionsThe 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.