Prophylactic mesh does not prevent parastomal hernia in long-term: Meta-analysis and trial sequential analysis

Verdaguer-Tremolosa, Mireia; Garcia-Alamino, Josep Maria; Rodrigues-Gonçalves, Victor; Martínez-López, Maria Pilar; López-Cano, Manuel

doi:10.1016/j.surg.2023.09.038

Surgery

2024

DOI: 10.1016/j.surg.2023.09.038

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Prophylactic mesh does not prevent parastomal hernia in long-term: Meta-analysis and trial sequential analysis

Mireia Verdaguer-Tremolosa,

Josep Maria Garcia-Alamino,

Victor Rodrigues-Gonçalves

et al.

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2024

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Cited by 7 publications

(1 citation statement)

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“…In conclusion, the decision to reduce the risk of a PH with prosthetic mesh should not be taken lightly. It is a choice that has significant implications for health outcomes and quality of life, with recent literature questioning the effectiveness of non-absorbable synthetic mesh in preventing PH in the context of an end colostomy when long-term follow-up is considered [ 14 ]. The SDM model emerges as an invaluable tool to ensure that an informed, balanced decision is made, aligned with the individual values and desires of the patient.…”

mentioning

confidence: 99%

The Importance of Shared Decision Making in the Decision to Prevent a Parastomal Hernia With Prosthetic Mesh

López-Cano,

García-Alamino

2023

J. Abdom. Wall Surg.

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mentioning

confidence: 99%

The Importance of Shared Decision Making in the Decision to Prevent a Parastomal Hernia With Prosthetic Mesh

López-Cano,

García-Alamino

2023

J. Abdom. Wall Surg.

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Parastomal hernia prevention with an intraperitoneal prophylactic 3D-funnel mesh: review of the technique and middle-term results

Badia-Closa,

Comas-Isus,

Centeno-Alvarez

et al. 2024

Hernia

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Umbrella review of systematic reviews on the efficacy and safety of using mesh in the prevention of parastomal hernias

Emile,

Dourado,

Rogers

et al. 2024

Hernia

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Background This umbrella review aimed to summarize the findings and conclusions of published systematic reviews on the prophylactic role of mesh against parastomal hernias in colorectal surgery. Methods PRISMA-compliant umbrella overview of systematic reviews on the role of mesh in prevention of parastomal hernias was conducted. PubMed and Scopus were searched through November 2023. Main outcomes were efficacy and safety of mesh. Efficacy was assessed by the rates of clinically and radiologically detected hernias and the need for surgical repair, while safety was assessed by the rates of overall complications. Results 19 systematic reviews were assessed; 7 included only patients with end colostomy and 12 included patients with either ileostomy or colostomy. The use of mesh significantly reduced the risk of clinically detected parastomal hernias in all reviews except one. Seven reviews reported a significantly lower risk of radiologically detected parastomal hernias with the use of mesh. The pooled hazards ratio of clinically detected and radiologically detected parastomal hernias was 0.33 (95%CI: 0.26–0.41) and 0.55 (95%CI: 0.45–0.68), respectively. Six reviews reported a significant reduction in the need for surgical repair when a mesh was used whereas six reviews found a similar need for hernia repair. The pooled hazards ratio for surgical hernia repair was 0.46 (95%CI: 0.35–0.62). Eight reviews reported similar complications in the two groups. The pooled hazard ratio of complications was 0.81 (95%CI: 0.66-1). Conclusions The use of surgical mesh is likely effective and safe in the prevention of parastomal hernias without an increased risk of overall complications.

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Prophylactic mesh does not prevent parastomal hernia in long-term: Meta-analysis and trial sequential analysis

Cited by 7 publications

References 51 publications

The Importance of Shared Decision Making in the Decision to Prevent a Parastomal Hernia With Prosthetic Mesh

The Importance of Shared Decision Making in the Decision to Prevent a Parastomal Hernia With Prosthetic Mesh

Parastomal hernia prevention with an intraperitoneal prophylactic 3D-funnel mesh: review of the technique and middle-term results

Umbrella review of systematic reviews on the efficacy and safety of using mesh in the prevention of parastomal hernias

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