Outcomes of surgical techniques for parastomal hernia repair: a bayesian network meta-analysis
- 01.12.2026
- Review
Erschienen in:
- Verfasst von
- Jose Martín-Arévalo
- Victoria Alejandra Lopez-Callejon
- David Moro-Valdezate
- Stephanie Anne Garcia-Botello
- Leticia Perez-Santiago
- Monica Millan
- Fernando Lopez-Mozos
- Guillermo Lillo-Albert
- Julieta Puente-Monserrat
- Vicente Pla-Marti
- Erschienen in
- Hernia | Ausgabe 1/2026
Abstract
Objectives
To determine the relative efficacy and safety of surgical techniques for parastomal hernia (PH) repair using a Bayesian network meta-analysis (NMA), integrating direct and indirect evidence to generate probabilistic rankings and guide clinical decision-making.
Methods
We conducted a systematic review and Bayesian NMA of 28 studies (1.983) patients) comparing seven PH repair techniques, following PRISMA-NMA guidelines. The primary outcome was parastomal hernia (PH) recurrence; the secondary outcome was cumulative postoperative complications. Random-effects models with a binomial likelihood and a logit link function were used. SUCRA probabilities ranked interventions; node-splitting assessed inconsistency; meta-regression evaluated covariates.
Results
FunnelMesh achieved the highest SUCRA score for recurrence reduction (91.55%), significantly outperforming Keyhole (OR 0.06, 95% CrI: 0.01–0.35) and Repair (OR 0.11, 95% CrI: 0.02–0.55). Sandwich ranked second (80%). For complications, Modified Keyhole (KeyholeM) ranked safest (SUCRA = 91%), with a significantly lower complication risk than Sugarbaker (OR = 0.23; 95% CrI: 0.05–0.94) and Keyhole (OR = 0.22; 95% CrI: 0.04–0.92). Node-splitting revealed inconsistencies in the FunnelMesh comparisons, warranting cautious interpretation. Meta-regression confirmed robustness across stoma type, approach, and follow-up duration.
Conclusions
FunnelMesh and Sandwich offered superior recurrence prevention; KeyholeM provides the optimal balance of low recurrence and minimal complications. The traditional Keyhole technique remained associated with high failure rates, reinforcing current guideline recommendations against its use. These findings provide an evidence-based framework to individualize PH repair strategies based on efficacy and safety trade-offs.
Highlights
-
Bayesian network meta-analysis comparing all major techniques for parastomal hernia repair.
-
FunnelMesh, Sandwich, and modified Keyhole achieve the best balance of efficacy and safety.
-
Provides an evidence-based framework to guide surgical selection and patient counseling.
Anzeige
- Titel
- Outcomes of surgical techniques for parastomal hernia repair: a bayesian network meta-analysis
- Verfasst von
-
Jose Martín-Arévalo
Victoria Alejandra Lopez-Callejon
David Moro-Valdezate
Stephanie Anne Garcia-Botello
Leticia Perez-Santiago
Monica Millan
Fernando Lopez-Mozos
Guillermo Lillo-Albert
Julieta Puente-Monserrat
Vicente Pla-Marti
- Publikationsdatum
- 01.12.2026
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2026
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03534-1
Dieser Inhalt ist nur sichtbar, wenn du eingeloggt bist und die entsprechende Berechtigung hast.
Dieser Inhalt ist nur sichtbar, wenn du eingeloggt bist und die entsprechende Berechtigung hast.
