Efficiency and safety of continuous barbed suture for fascial closure in minimally invasive colorectal surgery: A propensity score-matched analysis

Surgical-site infections and incisional hernias remain significant challenges in colorectal cancer surgery. While minimally invasive techniques reduce surgical trauma, the optimal fascial closure method for small incisions to prevent these complications has not been definitively established. This study evaluated the efficacy of continuous barbed suturing in streamlining surgical workflow and its safety regarding postoperative complications compared to traditional simple interrupted suturing. We retrospectively analyzed 220 patients undergoing elective minimally invasive colorectal cancer surgery. To ensure a robust comparison, propensity score matching was employed to balance baseline characteristics between the continuous barbed suture and simple interrupted suture groups. Our results demonstrated that the incidences of surgical-site infections and incisional hernias, confirmed by CT imaging at 12 months, did not differ significantly between the two techniques. However, the mean fascia closure time was significantly reduced in the continuous barbed suture group (4.9 min) compared to the simple interrupted group (11.8 min) (p<0.001) (Post-PSM). These findings indicate that continuous barbed suturing for small-incision closure is safe, reliable, and significantly more efficient than conventional methods. By reducing operative stress and procedural time, this technique represents a superior alternative to traditional methods and has the potential to become the gold standard for fascial management in minimally invasive colorectal surgery.