Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART)

J. Torkington; R. Harries; S. O'Connell; L. Knight; S. Islam; N. Bashir; A. Watkins; G. Fegan; J. Cornish; B. Rees; H. Cole; H. Jarvis; S. Jones; Russell; D. Bosanquet; A. Cleves; B. Sewell; A. Farr; N. Zbrzyzna; N. Fiera; R. Ellis-Owen; Z. Hilton; C. Parry; A. Bradbury; T. Rockall; A. Windsor; Allgar; W. Hollingworth; C. Lovell-Smith; J. Hepburn; M. Gudgeon; R. Gabe; C. Thomson; P. Wall; J. Hill; D. Winter; K. Cocks; D. Harris; J. Hilton; S. Vakis; D. Hanratty; R. Rajagopal; F. Akbar; A. Ben-Sassi; N. Francis; L. Jones; M. Williamson; Lindsey; R. West; C. Smart; P. Ziprin; T. Agarwal; G. Faulkner; T. Pinkney; D. Vimalachandran; D. Lawes; O. Faiz; P. Nisar; N. Smart; T. Wilson; A. Myers; J. Lund; S. Smolarek; A. Acheson; J. Horwood; J. Ansell; S. Phillips; M. Davies; L. Davies; S. Bird; N. Palmer; M. Williams; G. Galanopoulos; P. Dhruva Rao; D. Jones; R. Barnett; S. Tate; J. Wheat; N. Patel; S. Rahmani; E. Toynton; L. Smith; N. Reeves; E. Kealaher; G. Williams; C. Sekaran; M. Evans; J. Beynon; R. Egan; E. Qasem; U. Khot; S. Ather; P. Mummigati; G. Taylor; J. Williamson; J. Lim; A. Powell; H. Nageswaran; A. Williams; J. Padmanabhan; K. Phillips; T. Ford; J. Edwards; N. Varney; L. Hicks; C. Greenway; K. Chesters; H. Jones; P. Blake; C. Brown; L. Roche; M. Feeney; P. Shah; C. Rutter; C. McGrath; N. Curtis; L. Pippard; J. Perry; J. Allison; J. Ockrim; R. Dalton; A. Allison; J. Rendell; L. Howard; K. Beesley; G. Dennison; J. Burton; G. Bowen; S. Duberley; L. Richards; J. Giles; J. Katebe; S. Dalton; J. Wood; E. Courtney; R. Hompes; A. Poole; S. Ward; L. Wilkinson; L. Hardstaff; M. Bogden; M. Al-Rashedy; C. Fensom; N. Lunt; M. McCurrie; R. Peacock; K. Malik; H. Burns; B. Townley; P. Hill; M. Sadat; U. Khan; C. Wignall; D. Murati; M. Dhanaratne; S. Quaid; S. Gurram; D. Smith; P. Harris; J. Pollard; G. DiBenedetto; J. Chadwick; R. Hull; S. Bach; D. Morton; K. Hollier; Hardy; M. Ghods; D. Tyrrell; S. Ashraf; J. Glasbey; M. Ashraf; S. Garner; A. Whitehouse; D. Yeung; S. Noor Mohamed; R. Wilkin; N. Suggett; C. Lee; A. Bagul; C. McNeill; N. Eardley; R. Mahapatra; C. Gabriel; P. Datt; S. Mahmud; Daniels; F. McDermott; M. Nodolsk; L. Park; H. Scott; J. Trickett; P. Bearn; P. Trivedi; Frost; C. Gray; M. Croft; D. Beral; J. Osborne; R. Pugh; G. Herdman; R. George; A-M Howell; S. Al-Shahaby; B. Narendrakumar; Y. Mohsen; S. Ijaz; M. Nasseri; P. Herrod; T. Brear; J-J Reilly; A. Sohal; C. Otieno; W. Lai; M. Coleman; E. Platt; A. Patrick; C. Pitman; S. Balasubramanya; E. Dickson; R. Warman; C. Newton; S. Tani; J. Simpson; A. Banerjee; A. Siddika; D. Campion; D. Humes; N. Randhawa; J. Saunders; B. Bharathan; O. Hay; HART Collaborative

doi:10.1093/bjs/znac198

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Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART)

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Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART)

J. Torkington, R. Harries, S. O'Connell, L. Knight, S. Islam, N. Bashir, A. Watkins, G. Fegan, J. Cornish, B. Rees, …

British journal of surgery, Vol.109(10), pp.943-950

09/09/2022

DOI: https://doi.org/10.1093/bjs/znac198

PMID: 35979802

Abstract

Life Sciences & Biomedicine

Science & Technology

Surgery

Background: Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery. Methods: A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colorectal cancer to either Hughes closure (double far-near-near-far sutures of 1 nylon suture at 2-cm intervals along the fascia combined with conventional mass closure) or the surgeon's standard closure. The primary outcome was the incidence of incisional hernia at 1 year assessed by clinical examination. An intention-to-treat analysis was performed. Results: Between August 2014 and February 2018, 802 patients were randomized to either Hughes closure (401) or the standard mass closure group (401). At 1 year after surgery, 672 patients (83.7 per cent) were included in the primary outcome analysis; 50 of 339 patients (14.8 per cent) in the Hughes group and 57 of 333 (17.1 per cent) in the standard closure group had incisional hernia (OR 0.84, 95 per cent c.i. 0.55 to 1.27; P = 0.402). At 2 years, 78 patients (28.7 per cent) in the Hughes repair group and 84 (31.8 per cent) in the standard closure group had incisional hernia (OR 0.86, 0.59 to 1.25; P = 0.429). Adverse events were similar in the two groups, apart from the rate of surgical-site infection, which was higher in the Hughes group (13.2 versus 7.7 per cent; OR 1.82, 1.14 to 2.91; P = 0.011). Conclusion: The incidence of incisional hernia after colorectal cancer surgery is high. There was no statistical difference in incidence between Hughes closure and mass closure at 1 or 2 years.

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Title: Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART)
Creators - without role: J. Torkington - Univ Hosp Wales, Cardiff, Wales
R. Harries - Swansea Bay Univ Hlth Board, Swansea, W Glam, Wales
S. O'Connell - Cedar Healthcare Technol Res Ctr, Cardiff, Wales
L. Knight - Cedar Healthcare Technol Res Ctr, Cardiff, Wales
S. Islam - Swansea Trials Unit, Swansea, W Glam, Wales
N. Bashir - Swansea Trials Unit, Swansea, W Glam, Wales
A. Watkins - Swansea Trials Unit, Swansea, W Glam, Wales
G. Fegan - Swansea Trials Unit, Swansea, W Glam, Wales
J. Cornish - Cardiff & Vale Univ Hlth Board, Cardiff, Wales
B. Rees - Univ Hosp Wales, Cardiff, Wales
H. Cole - Univ Hosp Wales, Cardiff, Wales
H. Jarvis - Univ Hosp Wales, Cardiff, Wales
S. Jones - Univ Hosp Wales, Cardiff, Wales
Russell - Univ Hosp Wales, Cardiff, Wales
D. Bosanquet - Univ Hosp Wales, Cardiff, Wales
A. Cleves - Univ Hosp Wales, Cardiff, Wales
B. Sewell - Univ Hosp Wales, Cardiff, Wales
A. Farr - Univ Hosp Wales, Cardiff, Wales
N. Zbrzyzna - Univ Hosp Wales, Cardiff, Wales
N. Fiera - Univ Hosp Wales, Cardiff, Wales
R. Ellis-Owen - Univ Hosp Wales, Cardiff, Wales
Z. Hilton - Univ Hosp Wales, Cardiff, Wales
C. Parry - Univ Hosp Wales, Cardiff, Wales
A. Bradbury - Univ Hosp Wales, Cardiff, Wales
T. Rockall - Univ Hosp Wales, Cardiff, Wales
A. Windsor - Univ Hosp Wales, Cardiff, Wales
Allgar - Univ Hosp Wales, Cardiff, Wales
W. Hollingworth - Univ Hosp Wales, Cardiff, Wales
C. Lovell-Smith - Univ Hosp Wales, Cardiff, Wales
J. Hepburn - Univ Hosp Wales, Cardiff, Wales
M. Gudgeon - Univ Hosp Wales, Cardiff, Wales
R. Gabe - Univ Hosp Wales, Cardiff, Wales
C. Thomson - Univ Hosp Wales, Cardiff, Wales
P. Wall - Univ Hosp Wales, Cardiff, Wales
J. Hill - Univ Hosp Wales, Cardiff, Wales
D. Winter - Univ Hosp Wales, Cardiff, Wales
K. Cocks - Univ Hosp Wales, Cardiff, Wales
D. Harris - Singleton Hosp, Swansea, W Glam, Wales
J. Hilton - Princess Wales Hosp, Bridgend, England
S. Vakis - Queens Hosp, Burton Upon Trent, England
D. Hanratty - Royal Glamorgan Hosp, Llantrist, England
R. Rajagopal - Glan Clwd Hosp, Rhyl, England
F. Akbar - Glan Clwd Hosp, Rhyl, England
A. Ben-Sassi - Wrexham Maelor Hosp, Wrexham, Wales
N. Francis - Yeovil Dist Hosp, Yeovil, England
L. Jones - Royal Blackburn Hosp, Blackburn, Lancs, England
M. Williamson
Lindsey - Churchill Hosp, Oxford, England
R. West - Weston Gen Hosp, Weston Super Mare, England
C. Smart - Macclesfield Hosp, Macclesfield, Cheshire, England
P. Ziprin - St Marys Hosp, London, England
T. Agarwal - Ealing Gen Hosp, London, England
G. Faulkner - Royal Bolton Hosp, Bolton, England
T. Pinkney - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
D. Vimalachandran - Countess Chester Hosp, Chester, Cheshire, England
D. Lawes - Maidstone Dist Hosp, Maidstone, Kent, England
O. Faiz - St Marks Hosp, London, England
P. Nisar - St Peters Hosp, Chertsey, England
N. Smart - Phillips Exeter Academy
T. Wilson - Doncaster Royal Infirm, Doncaster, England
A. Myers - Hillingdon Hosp, Uxbridge, Middx, England
J. Lund - Royal Derby Hosp, Derby, England
S. Smolarek - Derriford Hosp, Plymouth, Devon, England
A. Acheson - College Station Medical Center
J. Horwood - Univ Hosp Wales, Cardiff, Wales
J. Ansell - Univ Hosp Wales, Cardiff, Wales
S. Phillips - Univ Hosp Wales, Cardiff, Wales
M. Davies - Univ Hosp Wales, Cardiff, Wales
L. Davies - Univ Hosp Wales, Cardiff, Wales
S. Bird - Univ Hosp Wales, Cardiff, Wales
N. Palmer - Univ Hosp Wales, Cardiff, Wales
M. Williams - Univ Hosp Wales, Cardiff, Wales
G. Galanopoulos - Univ Hosp Wales, Cardiff, Wales
P. Dhruva Rao - Univ Hosp Wales, Cardiff, Wales
D. Jones - Univ Hosp Wales, Cardiff, Wales
R. Barnett - Univ Hosp Wales, Cardiff, Wales
S. Tate - Univ Hosp Wales, Cardiff, Wales
J. Wheat - Univ Hosp Wales, Cardiff, Wales
N. Patel - Univ Hosp Wales, Cardiff, Wales
S. Rahmani - Univ Hosp Wales, Cardiff, Wales
E. Toynton - Univ Hosp Wales, Cardiff, Wales
L. Smith - Univ Hosp Wales, Cardiff, Wales
N. Reeves - Univ Hosp Wales, Cardiff, Wales
E. Kealaher - Univ Hosp Wales, Cardiff, Wales
G. Williams - Univ Hosp Wales, Cardiff, Wales
C. Sekaran - Singleton Hosp, Swansea, W Glam, Wales
M. Evans - Singleton Hosp, Swansea, W Glam, Wales
J. Beynon - Singleton Hosp, Swansea, W Glam, Wales
R. Egan - Singleton Hosp, Swansea, W Glam, Wales
E. Qasem - Singleton Hosp, Swansea, W Glam, Wales
U. Khot - Singleton Hosp, Swansea, W Glam, Wales
S. Ather - Singleton Hosp, Swansea, W Glam, Wales
P. Mummigati - Singleton Hosp, Swansea, W Glam, Wales
G. Taylor - Singleton Hosp, Swansea, W Glam, Wales
J. Williamson - Singleton Hosp, Swansea, W Glam, Wales
J. Lim - Singleton Hosp, Swansea, W Glam, Wales
A. Powell - Singleton Hosp, Swansea, W Glam, Wales
H. Nageswaran - Singleton Hosp, Swansea, W Glam, Wales
A. Williams - Singleton Hosp, Swansea, W Glam, Wales
J. Padmanabhan - Singleton Hosp, Swansea, W Glam, Wales
K. Phillips - Singleton Hosp, Swansea, W Glam, Wales
T. Ford - Singleton Hosp, Swansea, W Glam, Wales
J. Edwards - Singleton Hosp, Swansea, W Glam, Wales
N. Varney - Singleton Hosp, Swansea, W Glam, Wales
L. Hicks - Singleton Hosp, Swansea, W Glam, Wales
C. Greenway - Singleton Hosp, Swansea, W Glam, Wales
K. Chesters - Singleton Hosp, Swansea, W Glam, Wales
H. Jones - Singleton Hosp, Swansea, W Glam, Wales
P. Blake - Singleton Hosp, Swansea, W Glam, Wales
C. Brown - Singleton Hosp, Swansea, W Glam, Wales
L. Roche - Princess Wales Hosp, Bridgend, England
M. Feeney - Princess Wales Hosp, Bridgend, England
P. Shah - Royal Glamorgan Hosp, Llantrist, England
C. Rutter - Glan Clwyd Gen Hosp, Rhyl, England
C. McGrath - Wrexham Maelor Hosp, Wrexham, Wales
N. Curtis - Yeovil Dist Hosp, Yeovil, England
L. Pippard - Yeovil Dist Hosp, Yeovil, England
J. Perry - Yeovil Dist Hosp, Yeovil, England
J. Allison - Yeovil Dist Hosp, Yeovil, England
J. Ockrim - Yeovil Dist Hosp, Yeovil, England
R. Dalton - Yeovil Dist Hosp, Yeovil, England
A. Allison - Yeovil Dist Hosp, Yeovil, England
J. Rendell - Yeovil Dist Hosp, Yeovil, England
L. Howard - Yeovil Dist Hosp, Yeovil, England
K. Beesley - Yeovil Dist Hosp, Yeovil, England
G. Dennison - Yeovil Dist Hosp, Yeovil, England
J. Burton - Yeovil Dist Hosp, Yeovil, England
G. Bowen - Royal Blackburn Hosp, Blackburn, Lancs, England
S. Duberley - Royal Blackburn Hosp, Blackburn, Lancs, England
L. Richards - Royal Blackburn Hosp, Blackburn, Lancs, England
J. Giles - Royal Blackburn Hosp, Blackburn, Lancs, England
J. Katebe - Avon
S. Dalton - Avon
J. Wood - Avon
E. Courtney - Avon
R. Hompes - Churchill Hosp, Oxford, England
A. Poole - Churchill Hosp, Oxford, England
S. Ward - Macclesfield Hosp, Macclesfield, Cheshire, England
L. Wilkinson - Macclesfield Hosp, Macclesfield, Cheshire, England
L. Hardstaff - Macclesfield Hosp, Macclesfield, Cheshire, England
M. Bogden - Macclesfield Hosp, Macclesfield, Cheshire, England
M. Al-Rashedy - Macclesfield Hosp, Macclesfield, Cheshire, England
C. Fensom - Macclesfield Hosp, Macclesfield, Cheshire, England
N. Lunt - Macclesfield Hosp, Macclesfield, Cheshire, England
M. McCurrie - Macclesfield Hosp, Macclesfield, Cheshire, England
R. Peacock - Macclesfield Hosp, Macclesfield, Cheshire, England
K. Malik - Macclesfield Hosp, Macclesfield, Cheshire, England
H. Burns - Macclesfield Hosp, Macclesfield, Cheshire, England
B. Townley - Macclesfield Hosp, Macclesfield, Cheshire, England
P. Hill - Macclesfield Hosp, Macclesfield, Cheshire, England
M. Sadat - Macclesfield Hosp, Macclesfield, Cheshire, England
U. Khan - Macclesfield Hosp, Macclesfield, Cheshire, England
C. Wignall - St Marys Hosp, London, England
D. Murati - Ealing Gen Hosp, London, England
M. Dhanaratne - Ealing Gen Hosp, London, England
S. Quaid - Ealing Gen Hosp, London, England
S. Gurram - Ealing Gen Hosp, London, England
D. Smith - Royal Bolton Hosp, Bolton, England
P. Harris - Royal Bolton Hosp, Bolton, England
J. Pollard - Royal Bolton Hosp, Bolton, England
G. DiBenedetto - Royal Bolton Hosp, Bolton, England
J. Chadwick - Royal Bolton Hosp, Bolton, England
R. Hull - Royal Bolton Hosp, Bolton, England
S. Bach - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
D. Morton - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
K. Hollier - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
Hardy - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
M. Ghods - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
D. Tyrrell - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
S. Ashraf - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
J. Glasbey - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
M. Ashraf - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
S. Garner - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
A. Whitehouse - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
D. Yeung - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
S. Noor Mohamed - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
R. Wilkin - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
N. Suggett - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
C. Lee - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
A. Bagul - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
C. McNeill - Queen Elizabeth II Hosp, Birmingham, W Midlands, England
N. Eardley - Countess Chester Hosp, Chester, Cheshire, England
R. Mahapatra - Countess Chester Hosp, Chester, Cheshire, England
C. Gabriel - Countess Chester Hosp, Chester, Cheshire, England
P. Datt - St Marks Hosp, London, England
S. Mahmud - St Marks Hosp, London, England
Daniels - Phillips Exeter Academy
F. McDermott - Phillips Exeter Academy
M. Nodolsk - Phillips Exeter Academy
L. Park - Phillips Exeter Academy
H. Scott - St Peters Hosp, Chertsey, England
J. Trickett - St Peters Hosp, Chertsey, England
P. Bearn - St Peters Hosp, Chertsey, England
P. Trivedi - St Peters Hosp, Chertsey, England
Frost - St Peters Hosp, Chertsey, England
C. Gray - Phillips Exeter Academy
M. Croft - Phillips Exeter Academy
D. Beral - Doncaster Royal Infirm, Doncaster, England
J. Osborne - Doncaster Royal Infirm, Doncaster, England
R. Pugh - Doncaster Royal Infirm, Doncaster, England
G. Herdman - Doncaster Royal Infirm, Doncaster, England
R. George - Doncaster Royal Infirm, Doncaster, England
A-M Howell - Hillingdon Hosp, Uxbridge, Middx, England
S. Al-Shahaby - Hillingdon Hosp, Uxbridge, Middx, England
B. Narendrakumar - Hillingdon Hosp, Uxbridge, Middx, England
Y. Mohsen - Hillingdon Hosp, Uxbridge, Middx, England
S. Ijaz - Hillingdon Hosp, Uxbridge, Middx, England
M. Nasseri - Hillingdon Hosp, Uxbridge, Middx, England
P. Herrod - Royal Derby Hosp, Derby, England
T. Brear - Royal Derby Hosp, Derby, England
J-J Reilly - Royal Derby Hosp, Derby, England
A. Sohal - Royal Derby Hosp, Derby, England
C. Otieno - Royal Derby Hosp, Derby, England
W. Lai - Derriford Hosp, Plymouth, Devon, England
M. Coleman - Derriford Hosp, Plymouth, Devon, England
E. Platt - Derriford Hosp, Plymouth, Devon, England
A. Patrick - Derriford Hosp, Plymouth, Devon, England
C. Pitman - Derriford Hosp, Plymouth, Devon, England
S. Balasubramanya - Derriford Hosp, Plymouth, Devon, England
E. Dickson - College Station Medical Center
R. Warman - College Station Medical Center
C. Newton - College Station Medical Center
S. Tani - College Station Medical Center
J. Simpson - College Station Medical Center
A. Banerjee - College Station Medical Center
A. Siddika - College Station Medical Center
D. Campion - College Station Medical Center
D. Humes - College Station Medical Center
N. Randhawa - College Station Medical Center
J. Saunders - College Station Medical Center
B. Bharathan - College Station Medical Center
O. Hay - College Station Medical Center
HART Collaborative
Publication Details: British journal of surgery, Vol.109(10), pp.943-950
Publisher: Oxford Univ Press
Number of pages: 8
Grant note: National Institute for Health Research (NIHR); National Institute for Health & Care Research (NIHR)
Identifiers: 9921677508331
Academic Unit: King Saud Bin Abdulaziz University for Health Sciences
Language: English
Resource Type: Journal article