Scholarlink

Background <p>Incisional hernia (IH) at extraction sites remains a common late complication of minimally invasive colorectal surgery. Closure technique is a potentially modifiable factor; however, evidence comparing continuous and interrupted fascial closure in this setting is limited.</p> Methods <p>We conducted a retrospective single-center cohort study involving 397 patients who underwent laparoscopic or robotic colorectal cancer resection by a single surgeon between April 2019 and May 2025. Interrupted fascial closure was routinely performed until March 2022, after which continuous closure was exclusively performed. Primary outcome was 1-year incidence of IH, which was assessed using standardized abdominal computed tomography. Secondary outcomes included perioperative outcomes and postoperative complications.</p> Results <p>Baseline demographics and tumor characteristics were comparable between 213 and 184 patients in interrupted and continuous closure groups, respectively. Robot-assisted procedures were more common in the continuous group (37.0% vs. 13.6%, <i>P</i> &#xa0;&lt; 0.001), whereas other perioperative factors were similar in both groups. At 1&#xa0;year, the overall incidence of IH was 14.9%. Continuous closure was associated with a significantly lower IH rate than interrupted closure (10.9% vs. 18.3%, <i>P</i> = 0.047). Multivariate logistic regression identified body mass index of ≥&#xa0; 25&#xa0;kg/m<sup>2</sup> (odds ratio [OR], 2.29; 95% confidence interval [CI] 1.27–4.16, <i>P</i> = 0.006) and interrupted closure (OR, 1.89; 95% CI 1.05–3.40, <i>P</i> = 0.035) as independent predictors of IH. Rates of surgical site infection and other early complications did not differ significantly between the groups.</p> Conclusion <p>Continuous fascial closure using absorbable barbed sutures was associated with a significantly reduced incidence of IH, without increasing short-term morbidity. These findings suggest that closure technique may represent a modifiable determinant of IH risk and support continuous closure as a potentially preferable approach. However, prospective multicenter randomized controlled trials are warranted to validate these results and confirm their generalizability.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Continuous fascial closure using absorbable barbed sutures lowers the risk of incisional hernia after minimally invasive colorectal surgery: a consecutive single-surgeon retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年1月20日

查看全文
  • Kentaro Sato,
  • Toshiki Mukai,
  • Yutaro Kamei,
  • Tatsuki Noguchi,
  • Takashi Sakamoto,
  • Shimpei Matsui,
  • Tomohiro Yamaguchi,
  • Takashi Akiyoshi

摘要

Background

Incisional hernia (IH) at extraction sites remains a common late complication of minimally invasive colorectal surgery. Closure technique is a potentially modifiable factor; however, evidence comparing continuous and interrupted fascial closure in this setting is limited.

Methods

We conducted a retrospective single-center cohort study involving 397 patients who underwent laparoscopic or robotic colorectal cancer resection by a single surgeon between April 2019 and May 2025. Interrupted fascial closure was routinely performed until March 2022, after which continuous closure was exclusively performed. Primary outcome was 1-year incidence of IH, which was assessed using standardized abdominal computed tomography. Secondary outcomes included perioperative outcomes and postoperative complications.

Results

Baseline demographics and tumor characteristics were comparable between 213 and 184 patients in interrupted and continuous closure groups, respectively. Robot-assisted procedures were more common in the continuous group (37.0% vs. 13.6%, P  < 0.001), whereas other perioperative factors were similar in both groups. At 1 year, the overall incidence of IH was 14.9%. Continuous closure was associated with a significantly lower IH rate than interrupted closure (10.9% vs. 18.3%, P = 0.047). Multivariate logistic regression identified body mass index of ≥  25 kg/m2 (odds ratio [OR], 2.29; 95% confidence interval [CI] 1.27–4.16, P = 0.006) and interrupted closure (OR, 1.89; 95% CI 1.05–3.40, P = 0.035) as independent predictors of IH. Rates of surgical site infection and other early complications did not differ significantly between the groups.

Conclusion

Continuous fascial closure using absorbable barbed sutures was associated with a significantly reduced incidence of IH, without increasing short-term morbidity. These findings suggest that closure technique may represent a modifiable determinant of IH risk and support continuous closure as a potentially preferable approach. However, prospective multicenter randomized controlled trials are warranted to validate these results and confirm their generalizability.

Graphical Abstract