A randomized controlled trial comparing large versus small stitch incision closure in gynaecological malignancies (CLaSSIC Study)

IF 2.4 Q3 Medicine

Cancer treatment and research communications Pub Date : 2025-01-01 DOI:10.1016/j.ctarc.2025.100987

Priya Bhati , Monal Garg , Saumya Gupta , Hawwa Hana , Anandita Anandita , Sheejamol V S

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引用次数: 0

Abstract

Objective

The study aimed to compare Small Stitch Closure (SSC) and Large Stitch Closure (LSC) techniques for reducing incisional ventral hernia (IVH) and surgical site infection (SSI) rates in gynaecological malignancies.

Methods

We conducted a single-blind, randomised controlled trial at our gynaecological oncology department. Patients aged ≥18 years scheduled for elective oncological surgery with midline laparotomy were randomly assigned to receive small stitches of 5 mm every 5 mm or large stitches of 1 cm every 1 cm.

Results

Between March 1, 2022, and August 13, 2023, 218 patients were randomly assigned to either the LSC group (n = 110) or the SSC group (n = 108). Follow-up ended on August 20, 2024, with 213 patients completing it. After one year, the SSC group had significantly lower rates of IVH at 3.7 % compared to 12.1 % for the LSC group (p = 0.02); this difference remained significant in multivariate analysis (p = 0.04, OR: 5.78). SSI rates were similar, with the LSC group at 2.8 % and the SSC group at 3.5 % (p = 0.11). In the multivariate analysis, preoperative chemotherapy was significantly associated with IVH (p = 0.04, OR: 3.83), while a postoperative hospital stay of 72 h or more increased the risk of SSI (p = 0.02, OR: 11.51).

Conclusion

LSC was associated with a significantly higher rate of IVH compared to SSC, while SSI rates were similar between both groups. Preoperative chemotherapy was a key factor influencing IVH, and a longer postoperative hospital stay led to increased SSI rates.

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一项比较妇科恶性肿瘤大切口与小切口闭合的随机对照试验（经典研究）

目的比较小针缝合术（SSC）和大针缝合术（LSC）在降低妇科恶性肿瘤切口腹疝（IVH）和手术部位感染（SSI）发生率方面的效果。方法在我院妇科肿瘤科进行单盲、随机对照试验。年龄≥18岁的择期肿瘤手术伴剖腹中线开腹的患者被随机分配到每5mm 5mm的小缝线或每1cm的大缝线。在2022年3月1日至2023年8月13日期间，218名患者被随机分配到LSC组（n = 110）或SSC组（n = 108）。随访于2024年8月20日结束，共有213例患者完成随访。一年后，SSC组IVH发生率为3.7%，显著低于LSC组的12.1% (p = 0.02)；在多变量分析中，这一差异仍然显著（p = 0.04, OR: 5.78）。SSI发生率相似，LSC组为2.8%，SSC组为3.5% （p = 0.11）。在多因素分析中，术前化疗与IVH显著相关（p = 0.04, OR: 3.83），而术后住院72 h及以上会增加SSI的风险（p = 0.02, OR: 11.51）。结论与SSC相比，lsc与IVH发生率显著升高，而SSI发生率在两组之间相似。术前化疗是影响IVH的关键因素，术后住院时间延长导致SSI发生率增加。

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

Cancer treatment and research communications Medicine-Oncology

CiteScore

4.30

自引率

0.00%

发文量

148

审稿时长

56 days

期刊介绍： Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.