Imperial College London
Paul Ziprin

Paul Ziprin

Faculty of Medicine, Department of Surgery & Cancer

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 3312 7635p.ziprin

 
 
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Assistant

 

Ms Caroline Hurley +44 (0)20 3312 2124

 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Smith:2023:10.1111/codi.16537,
author = {Smith, L and Coxon-Meggy, A and Shinkwin, M and Cornish, J and Watkins, A and Fegan, G and Torkington, J and HART, Trial Collaborators},
doi = {10.1111/codi.16537},
journal = {Colorectal Dis},
pages = {1222--1227},
title = {"Happy to close?" The relationship between surgical experience and incisional hernia rates following abdominal wall closure in colorectal surgery.},
url = {http://dx.doi.org/10.1111/codi.16537},
volume = {25},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AIM: Incisional hernia (IH) is a common complication of colorectal surgery, affecting up to 30% of patients at 2 years. Given the associated morbidity and high recurrence rates after attempted repair of IH, emphasis should be placed on prevention. There is an association between surgeon volume and outcomes in hernia surgery, yet there is little evidence regarding impact of the seniority of the surgeon performing abdominal wall closure on IH rate. The aim of our study was to assess the rates of IH at 1 year following abdominal wall closure between junior and senior surgeons in patients undergoing elective colorectal surgery. METHODS: This was an exploratory analysis of patients who underwent elective surgery for colorectal cancer between 2014-2018 as part of the Hughes Abdominal Repair Trial (HART), a prospective, multicentre randomised control trial comparing abdominal wall closure methods. Grade of surgeon performing abdominal closure was categorised into "trainee" and "consultant" and compared to IH rate at one year. RESULTS: A total of 663 patients were included in this retrospective analysis of patients in the HART trial. The rate of IH in patients closed by trainees was 20%, compared to 12% in those closed by consultants (p = <0.001). When comparing closure methods, IH rates were significantly higher in the Hughes closure arm between trainees and consultants (20% vs. 12%, p = 0.032), but not high enough in the mass closure arm to reach statistical significance (21% vs. 13%, p = 0.058). On multivariate analysis, age (p = 0.036, OR: 1.02, 95% CI: 1.00-1.04), Male sex (p = 0.049, OR: 1.61, 95% CI: 1.00-2.59) and closure by a trainee (p = 0.006, OR: 1.85, 95% CI: 1.20-2.85) were identified as risk factors for developing IH. CONCLUSION: Patients who undergo abdominal wall closure by a surgeon in training have an increased risk of developing IH when compared to tho
AU  - Smith,L
AU  - Coxon-Meggy,A
AU  - Shinkwin,M
AU  - Cornish,J
AU  - Watkins,A
AU  - Fegan,G
AU  - Torkington,J
AU  - HART,Trial Collaborators
DO  - 10.1111/codi.16537
EP  - 1227
PY  - 2023///
SP  - 1222
TI  - "Happy to close?" The relationship between surgical experience and incisional hernia rates following abdominal wall closure in colorectal surgery.
T2  - Colorectal Dis
UR  - http://dx.doi.org/10.1111/codi.16537
UR  - https://www.ncbi.nlm.nih.gov/pubmed/36965056
VL  - 25
ER  -
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