Reinforced tension-line suture after laparotomy : early results of the Rein4CeTo1 randomized clinical trial
Wenzelberg, Charlotta L LU ; Rogmark, Peder LU
; Ekberg, Olle
LU
and Petersson, Ulf
(2024)
In The British journal of surgery
111(10).
- 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... (More)
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).
(Less)
- author
- Wenzelberg, Charlotta L
LU
; Rogmark, Peder
LU
; Ekberg, Olle
LU
and Petersson, Ulf
- organization
- publishing date
- 2024-09-03
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Humans, Male, Female, Incisional Hernia/prevention & control, Aged, Suture Techniques, Middle Aged, Colorectal Neoplasms/surgery, Sutures, Laparotomy/adverse effects, Polydioxanone/therapeutic use, Abdominal Wound Closure Techniques, Incidence, Polypropylenes
- in
- The British journal of surgery
- volume
- 111
- issue
- 10
- article number
- znae265
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85208168204
- pmid:39475416
- ISSN
- 1365-2168
- DOI
- 10.1093/bjs/znae265
- language
- English
- LU publication?
- yes
- id
- 896e9097-e440-40e1-9532-c4c06278b304
- date added to LUP
- 2024-12-09 09:36:10
- date last changed
- 2025-01-21 07:15:02
@article{896e9097-e440-40e1-9532-c4c06278b304,
abstract = {{<p>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.</p><p>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.</p><p>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.</p><p>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).</p>}},
author = {{Wenzelberg, Charlotta L and Rogmark, Peder and Ekberg, Olle and Petersson, Ulf}},
issn = {{1365-2168}},
keywords = {{Humans; Male; Female; Incisional Hernia/prevention & control; Aged; Suture Techniques; Middle Aged; Colorectal Neoplasms/surgery; Sutures; Laparotomy/adverse effects; Polydioxanone/therapeutic use; Abdominal Wound Closure Techniques; Incidence; Polypropylenes}},
language = {{eng}},
month = {{09}},
number = {{10}},
publisher = {{Oxford University Press}},
series = {{The British journal of surgery}},
title = {{Reinforced tension-line suture after laparotomy : early results of the Rein4CeTo1 randomized clinical trial}},
url = {{http://dx.doi.org/10.1093/bjs/znae265}},
doi = {{10.1093/bjs/znae265}},
volume = {{111}},
year = {{2024}},
}