Prophylactic mesh to prevent parastomal hernia: a meta-analysis of randomized controlled studies

• Published in: Techniques in coloproctology 2017, Vol.21 (1), p.5-13
• Main Authors: Patel, S. V., Zhang, L., Chadi, S. A., Wexner, S. D.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Colorectal Surgery; Gastroenterology; Hernia, Abdominal - etiology; Hernia, Abdominal - prevention & control; Humans; Incisional Hernia - etiology; Incisional Hernia - prevention & control; Medicine; Medicine & Public Health; Proctology; Randomized Controlled Trials as Topic; Review; Surgery; Surgical Mesh; Surgical Stomas - adverse effects
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-016-1559-7

The aim of the present meta-analysis was to determine whether prophylactic mesh decreases the odds of parastomal hernia formation. Randomized controlled trials referenced in MEDLINE or EMBASE between 1946 and 2016 comparing prophylactic mesh to standard stoma formation were included. The primary outcome was occurrence of parastomal hernia. Secondary outcomes were parastomal hernia requiring surgical intervention and complications. Odds ratios were calculated for the primary and secondary outcomes. Subgroup analyses were conducted based on mesh type, mesh location, laparoscopic versus open, and method of hernia diagnosis. Nine randomized controlled trials with 569 participants were included. There was a significant decrease in the odds of developing a parastomal hernia in the prophylactic mesh group [odds ratio (OR) 0.21, 95% confidence interval (CI) 0.11–0.38, p