Reinforced tension-line suture after laparotomy: early results of the Rein4CeTo1 randomized clinical trial.

IF 8.6 1区医学 Q1 SURGERY British Journal of Surgery Pub Date : 2024-09-03 DOI:10.1093/bjs/znae265

Charlotta L Wenzelberg, Peder Rogmark, Olle Ekberg, Ulf Petersson

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Abstract

Background: The aim was to investigate whether adding a reinforced tension-line (RTL) suture to a standard 4 : 1 small-bite closure would reduce the incidence of incisional hernia after colorectal cancer surgery.

Methods: Patients aged at least 18 years, who were scheduled for elective colorectal cancer surgery through a midline incision at two Swedish hospitals (2017-2021), were randomized in a 1 : 1 ratio to either fascial closure with RTL and 4 : 1 small-bite closure with polypropylene sutures (RTL group) or 4 : 1 small-bite closure with polydioxanone suture alone (PDS group). The primary outcome was CT-detected incisional hernia 1 year after surgery. CT interpreters were blinded regarding treatment group.

Results: In all, 160 patients were randomized, 80 in each group. The study closed early to recruitment and follow-up. Some 134 patients were analysed at 1 year: 63 in the RTL group and 71 in the PDS group. Nineteen patients were found to have an incisional hernia: 4 (6%) in the RTL group and 15 (21%) in the PDS group (OR 3.95, 95% c.i. 1.24 to 12.60; P = 0.014). No unintended effects were found in either group.

Conclusion: Adding an RTL suture at fascial closure decreased the incidence of incisional hernia in patients undergoing surgery for colorectal cancer. Trial registration: NCT03390764 (https://clinicaltrials.gov).

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开腹手术后加强张力线缝合：Rein4CeTo1 随机临床试验的早期结果。

背景：目的是研究在标准的4 : 1小口闭合术中加入加强张力线（RTL）缝合是否会降低结直肠癌术后切口疝的发生率：在两家瑞典医院（2017-2021年）安排通过中线切口进行选择性结直肠癌手术的至少18岁的患者，按1:1的比例随机分配到使用RTL和4:1小口缝合聚丙烯缝线的筋膜闭合（RTL组）或仅使用聚二氧酮缝线的4:1小口缝合（PDS组）。主要结果是术后 1 年 CT 检测到的切口疝。CT判读员对治疗组进行盲法判读：共有 160 名患者接受了随机治疗，每组 80 人。该研究提前结束了招募和随访。大约 134 名患者在术后 1 年接受了分析：RTL 组 63 人，PDS 组 71 人。19名患者被发现患有切口疝：其中 RTL 组 4 人（6%），PDS 组 15 人（21%）（OR 3.95，95% c.i. 1.24 至 12.60；P = 0.014）。两组均未发现意外影响：结论：在筋膜闭合处添加 RTL 缝合线可降低结直肠癌手术患者切口疝的发生率。试验注册：NCT03390764 (https://clinicaltrials.gov)。

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.