Impact of small-bite (5 mm) fascial closure on the incidence of incisional hernia following open colorectal cancer surgery: randomized clinical trial.

IF 8.6 1区医学 Q1 SURGERY

British Journal of Surgery Pub Date : 2024-08-02 DOI:10.1093/bjs/znae189

Cumhur Ozcan, Tahsin Colak, Ozgur Turkmenoglu, Mustafa Berkesoglu, Elif Ertas

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引用次数: 0

Abstract

Background: Incisional hernia is frequently observed after open colorectal cancer surgery, and should be considered a serious short- and long-term health issue. The present study evaluated the efficacy of small-bite abdominal closure in reducing the incidence of incisional hernia in this patient group.

Methods: An RCT was conducted between June 2019 and June 2022. A total of 173 patients who underwent open colorectal cancer surgery were assigned randomly to one of two groups to undergo fascial closure with either small bites (87) or conventional bites (86). The incisional hernia rate was accepted as the primary outcome, and surgical-site infection as the secondary outcome.

Results: The incisional hernia rates at 1 year were 7 and 27% in the small- and conventional-bite groups respectively (P < 0.001). This rate increased to 9 and 31% at the end of the second year (P < 0.001). Surgical-site infections occurred in 18% of the small-bite group and 31% of the conventional-bite group (P = 0.03). Compared with the conventional-bite group, the small-bite group had higher suture/wound length ratios (mean(s.d.) 5.18(0.84) versus 3.67(0.57); P < 0.001) and a longer fascial closure time 14.1(4.64) versus 12.9(2.39) min; P = 0.03).

Conclusion: Small-bite closure with 5-mm tissue bites placed 5 mm apart reduced the incidence of incisional hernia and surgical-site infection after open colorectal cancer surgery.

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小咬口（5 毫米）筋膜闭合对开放式结直肠癌手术后切口疝发生率的影响：随机临床试验。

背景：开放性结直肠癌手术后经常会出现切口疝，这应该被视为一个严重的短期和长期健康问题。本研究评估了小口腹腔闭合术在降低该患者群体切口疝发生率方面的疗效：方法：在2019年6月至2022年6月期间进行了一项RCT研究。共有 173 名接受开腹结直肠癌手术的患者被随机分配到两组中的一组，分别接受小咬口（87 例）或传统咬口（86 例）的筋膜闭合术。切口疝发生率为主要结果，手术部位感染为次要结果：小型咬合组和传统咬合组一年后的切口疝发生率分别为 7% 和 27%（P < 0.001）。第二年末，这一比例分别增至 9% 和 31%（P < 0.001）。小型咬合组和传统咬合组分别有18%和31%的患者发生手术部位感染（P = 0.03）。与传统咬合组相比，小咬合组的缝合/伤口长度比更高（平均值（s.d.）为 5.18(0.84) 对 3.67(0.57); P < 0.001），筋膜闭合时间更长，为 14.1(4.64) 对 12.9(2.39) 分钟; P = 0.03）：结论：使用间隔 5 毫米的 5 毫米组织咬合进行小咬合闭合可降低开放式结直肠癌手术后切口疝和手术部位感染的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Surgery 医学-外科

CiteScore

12.70

自引率

7.30%

发文量

1102

审稿时长

1.5 months

期刊介绍： The British Journal of Surgery (BJS), incorporating the European Journal of Surgery, stands as Europe's leading peer-reviewed surgical journal. It serves as an invaluable platform for presenting high-quality clinical and laboratory-based research across a wide range of surgical topics. In addition to providing a comprehensive coverage of traditional surgical practices, BJS also showcases emerging areas in the field, such as minimally invasive therapy and interventional radiology. While the journal appeals to general surgeons, it also holds relevance for specialty surgeons and professionals working in closely related fields. By presenting cutting-edge research and advancements, BJS aims to revolutionize the way surgical knowledge is shared and contribute to the ongoing progress of the surgical community.