Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis
Background. Parastomal hernia is a common complication after stoma formation, especially in permanent colostomy. The present meta-analysis aimed to evaluate the effectiveness of prophylactic mesh application during permanent colostomy for preventing parastomal hernia. Methods. Randomized controlled...
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| Format: | Article |
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Wiley
2016-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/1694265 |
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| author | JunJia Zhu YuWei Pu XiaoDong Yang DeBao Zhang Kui Zhao Wei Peng ChunGen Xing |
| author_facet | JunJia Zhu YuWei Pu XiaoDong Yang DeBao Zhang Kui Zhao Wei Peng ChunGen Xing |
| author_sort | JunJia Zhu |
| collection | DOAJ |
| description | Background. Parastomal hernia is a common complication after stoma formation, especially in permanent colostomy. The present meta-analysis aimed to evaluate the effectiveness of prophylactic mesh application during permanent colostomy for preventing parastomal hernia. Methods. Randomized controlled trials comparing outcomes in patients who underwent colostomy with or without prophylactic mesh application were identified from PubMed, EMBASE, Science Citation Index, and the Cochrane Libraries. Results. This meta-analysis included 8 randomized controlled trials with 522 participants. Our pooled results showed that prophylactic mesh application (mesh group) reduced the incidence of clinically detected parastomal hernia (risk ratio [RR]: 0.22; 95% confidence interval [CI]: 0.13–0.38; P<0.00001), radiologically detected parastomal hernia (RR: 0.62; 95% CI: 0.47–0.82; P=0.0008), and surgical repair for herniation (RR: 0.34; 95% CI: 0.14–0.83; P=0.02) when compared with conventional permanent colostomy formation (control group). The incidence of complications, including wound infection, peristomal infection, mesh infection, stomal necrosis and stenosis, stoma site pain, and fistula, was not higher in the mesh group than in the control group. Conclusions. Our meta-analysis demonstrated that prophylactic mesh application at the time of primary colostomy formation is a promising method for the prevention of parastomal herniation. |
| format | Article |
| id | doaj-art-ca31ef95f23f426093e27d8a41da3544 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
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| series | Gastroenterology Research and Practice |
| spelling | doaj-art-ca31ef95f23f426093e27d8a41da35442025-02-03T01:10:01ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/16942651694265Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-AnalysisJunJia Zhu0YuWei Pu1XiaoDong Yang2DeBao Zhang3Kui Zhao4Wei Peng5ChunGen Xing6Department of General Surgery, Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, ChinaDepartment of General Surgery, Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, ChinaDepartment of General Surgery, Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, ChinaDepartment of General Surgery, Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, ChinaDepartment of General Surgery, Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, ChinaDepartment of General Surgery, Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, ChinaDepartment of General Surgery, Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, ChinaBackground. Parastomal hernia is a common complication after stoma formation, especially in permanent colostomy. The present meta-analysis aimed to evaluate the effectiveness of prophylactic mesh application during permanent colostomy for preventing parastomal hernia. Methods. Randomized controlled trials comparing outcomes in patients who underwent colostomy with or without prophylactic mesh application were identified from PubMed, EMBASE, Science Citation Index, and the Cochrane Libraries. Results. This meta-analysis included 8 randomized controlled trials with 522 participants. Our pooled results showed that prophylactic mesh application (mesh group) reduced the incidence of clinically detected parastomal hernia (risk ratio [RR]: 0.22; 95% confidence interval [CI]: 0.13–0.38; P<0.00001), radiologically detected parastomal hernia (RR: 0.62; 95% CI: 0.47–0.82; P=0.0008), and surgical repair for herniation (RR: 0.34; 95% CI: 0.14–0.83; P=0.02) when compared with conventional permanent colostomy formation (control group). The incidence of complications, including wound infection, peristomal infection, mesh infection, stomal necrosis and stenosis, stoma site pain, and fistula, was not higher in the mesh group than in the control group. Conclusions. Our meta-analysis demonstrated that prophylactic mesh application at the time of primary colostomy formation is a promising method for the prevention of parastomal herniation.http://dx.doi.org/10.1155/2016/1694265 |
| spellingShingle | JunJia Zhu YuWei Pu XiaoDong Yang DeBao Zhang Kui Zhao Wei Peng ChunGen Xing Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis Gastroenterology Research and Practice |
| title | Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis |
| title_full | Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis |
| title_fullStr | Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis |
| title_full_unstemmed | Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis |
| title_short | Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis |
| title_sort | prophylactic mesh application during colostomy to prevent parastomal hernia a meta analysis |
| url | http://dx.doi.org/10.1155/2016/1694265 |
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