Use of prophylactic mesh to prevent parastomal hernia formation: a systematic review, meta-analysis and network meta-analysis
- 01.12.2025
- Review
Erschienen in:
- Verfasst von
- David E. Hinojosa-Gonzalez
- Gal Saffati
- Shane Kronstedt
- Troy La
- Madeline Chaput
- Shubh Desai
- Gustavo A. Salgado-Garza
- Sagar R. Patel
- Jackson Cathey
- Jeremy R. Slawin
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Purpose
To evaluate the effectiveness of prophylactic mesh placement in reducing the incidence of parastomal hernias following colostomy, ileostomy, and ileal conduit formation.
Methods
A systematic review identified relevant studies evaluating parastomal hernia incidence with prophylactic mesh use during stoma formation. Pairwise meta-analysis and network meta-analysis using Bayesian modeling were performed.
Results
25 studies, consisting of 16 randomized control trials (RCT), 6 follow up studies, and 3 retrospective cohort studies, were included. Prophylactic mesh led to significantly fewer parastomal hernias beyond 6 months follow-up (OR 0.43, 95% CI 0.33–0.58). Hernias were reduced with mesh for both ileal conduits and colostomies. When analyzing hazard ratios (HRs), only 6 studies were included, and a statistically significant difference was observed among both randomized controlled trials (RCTs) (HR 0.75 [0.53, 0.92], p = 0.01) and non-RCTs (HR 0.57 [0.36, 0.92], p = 0.02). Network meta-analysis found the retromuscular approach with mesh had the lowest hernia rate. Regression was non-significant for variations between study types.
Conclusion
This meta-analysis demonstrated prophylactic mesh placement during ostomy creation significantly reduced parastomal hernia risk, more prominently beyond 6 months, consistently across randomized trials and observational studies for urologic and gastrointestinal ostomies. The retromuscular technique was most effective.
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- Titel
- Use of prophylactic mesh to prevent parastomal hernia formation: a systematic review, meta-analysis and network meta-analysis
- Verfasst von
-
David E. Hinojosa-Gonzalez
Gal Saffati
Shane Kronstedt
Troy La
Madeline Chaput
Shubh Desai
Gustavo A. Salgado-Garza
Sagar R. Patel
Jackson Cathey
Jeremy R. Slawin
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-024-03219-1
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