Hernia After Colorectal Cancer Surgery

Defects in the abdominal wall (incisional hernia) is a frequent negative outcome after surgery. Reinforcing the incision with mesh seem to lower the incidence but in surgery that includes bowel resection a simple alternative, cheaper and less prone to infection than a synthetic mesh, would be of interest. The primary aim of this multicentre randomized controlled trial is to compare the incisional hernia incidence one year after planned colorectal cancer surgery performed through a midline incision which is closed either by a standardized small stitch 4:1 technique (the incision is closed with the use of suture of 4 times the length of the incision) or with the same technique plus a reinforced tension-line suture (a suture is applied in the fibrous tissue parallel to the incision which is then embraced by the 4:1 suture when the incision is closed). A difference in incisional hernia of 15% (20% without and 5% with reinforced tension-line suture) is assumed. Secondary aims are to evaluate incidences of wound dehiscence, other wound complications and incisional hernia after 3 years. Furthermore we aim to evaluate patient satisfaction and quality of life.

腹壁缺损，即切口疝（incisional hernia）是术后常见的不良结局。使用补片加固切口虽可降低其发生率，但在需行肠切除的手术中，一种相较于合成补片更简便、廉价且不易引发感染的替代方案具有重要研究价值。本项多中心随机对照试验的主要研究目的为：比较经正中切口行择期结直肠癌手术的患者，在术后1年时的切口疝发生率。两组切口闭合方式分别为：① 采用标准化4:1缝合法（缝线长度为切口长度的4倍）进行切口闭合；② 在上述4:1缝合法基础上，加用张力线加固缝合（即沿切口平行方向在纤维组织中置入缝线，待切口闭合时由4:1缝线环绕固定该缝线）。研究假设两组切口疝发生率差异为15%（未加张力线缝合组为20%，加用张力线缝合组为5%）。次要研究目的包括评估术后3年的伤口裂开、其他伤口并发症及切口疝发生率；此外还将评估患者满意度与生活质量。