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).
CONCLUSIONS: 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.
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).
CONCLUSIONS: 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.
摘要：
背景：开腹结直肠癌手术后经常观察到切口疝，应该被认为是一个严重的短期和长期健康问题。本研究评估了小咬伤腹部闭合术在降低该患者组中切口疝发生率方面的功效。
方法：在2019年6月至2022年6月之间进行了RCT。共有173例接受开放式结直肠癌手术的患者被随机分为两组，分别接受小咬伤（87例）或常规咬伤（86例）的筋膜闭合。切口疝发生率被认为是主要结果，和手术部位感染作为次要结果。
结果：小咬伤组和常规咬伤组的1年切口疝发生率分别为7％和27％（P<0.001）。该比率在第二年末增加到9%和31%(P<0.001)。手术部位感染发生在小咬伤组的18％和常规咬伤组的31％（P=0.03）。与常规咬伤组相比，小咬伤组的缝合/伤口长度比更高(平均(s.d.)5.18(0.84)对3.67(0.57);P<0.001),筋膜闭合时间14.1(4.64)对12.9(2.39)min;P=0.03).
结论：小咬合闭合5毫米的组织咬合可降低开腹结直肠癌手术后切口疝和手术部位感染的发生率。
方法：在2019年6月至2022年6月之间进行了RCT。共有173例接受开放式结直肠癌手术的患者被随机分为两组，分别接受小咬伤（87例）或常规咬伤（86例）的筋膜闭合。切口疝发生率被认为是主要结果，和手术部位感染作为次要结果。
结果：小咬伤组和常规咬伤组的1年切口疝发生率分别为7％和27％（P<0.001）。该比率在第二年末增加到9%和31%(P<0.001)。手术部位感染发生在小咬伤组的18％和常规咬伤组的31％（P=0.03）。与常规咬伤组相比，小咬伤组的缝合/伤口长度比更高(平均(s.d.)5.18(0.84)对3.67(0.57);P<0.001),筋膜闭合时间14.1(4.64)对12.9(2.39)min;P=0.03).
结论：小咬合闭合5毫米的组织咬合可降低开腹结直肠癌手术后切口疝和手术部位感染的发生率。
