Clinical assessment of stoma site marking.

Risk factors for parastomal hernia after abdominoperineal resection for rectal cancer

“…Since 2012, patients have received neoadjuvant chemoradiotherapy followed by a laparoscopic total mesorectal excision, and colostomy has been performed laparoscopically through the rectus abdominis muscle and an intraperitoneal route. In this procedure, the stoma site is preoperatively marked according to the principles of “stoma site marking” as proposed by the Cleveland Clinic . The stoma site is placed below the umbilicus, through the rectus abdominis muscle, at the belt line (at the top of a distended abdomen), away from skin folds, and at a place with adequate visibility for the patient.…”

The effect of preoperative stoma site marking on risk of stoma‐related complications in patients with intestinal ostomy — A systematic review and meta‐analysis

“…Eight studies received funding [21,22,24,26,52,[61][62][63]66], including two with for-profit funding (Hollister UK [63] and Coloplast [66]), while six studies did not [13,25,54,55,59,60]. Funding information was not available for the remaining studies [5,20,23,27,28,53,[56][57][58]64,65,67,68].…”

“…Some used the guidelines by the American Society of Colon and Rectal Surgeons [69] and the WOCN Society [21,22,25,26,53,61] or described a process involving assessment in a lying, sitting, and standing position [24,54,57,59]. Other studies utilised different criteria [13,23,27,28] or did not describe the process of marking in detail [5,20,52,55,56,58,60,[62][63][64][65][66][67][68]. In most studies, marking was performed either by a nurse [20][21][22]26,27,52,[54][55][56][59][60][61][62][63][64]66] and/or surgeon [13,24,25,53,…”

“…Stoma-related complications (early, late, minor and major) are defined as composite outcome as reported by included primary studies. Analysis of 3458 patients from 11 observational studies [5,13,20,22,23,28,[53][54][55]58,65] showed that marking may be associated with reduced risk of stoma-related complications (OR: 0.45, 95% CI: [0.31-0.65], I 2 = 71%, very low certainty, Figure 2A, Table 4).…”

“…First, they lack a comprehensive literature search which should include the search of the reference lists of included studies so that some studies were not included in one of the two systematic reviews [5,13,[20][21][22][23][24]. In addition, we identified studies not included in both previous reviews [25][26][27][28]. More so, important outcomes such as leakage or surgical revision were not considered, and the certainty of the evidence was not assessed.…”