Show simple item record

dc.contributor.authorCornille, J Ben
dc.contributor.authorPathak, Samiren
dc.contributor.authorDaniels, Ian R.en
dc.contributor.authorSmart, Neil J.en
dc.date.accessioned2016-06-10T14:58:31Z
dc.date.available2016-06-10T14:58:31Z
dc.date.issued2016-06-08
dc.identifier.citationProphylactic mesh use during primary stoma formation to prevent parastomal hernia. 2017 Jan;99(1):2-11. Epub 2016 Jun 8en
dc.identifier.issn1478-7083
dc.identifier.pmid27269439
dc.identifier.doi10.1308/rcsann.2016.0186
dc.identifier.urihttp://hdl.handle.net/11287/612529
dc.description.abstractINTRODUCTION Parastomal hernia (PSH) is a common problem following stoma formation. The optimal technique for stoma formation is unknown although recent studies have focused on whether placement of prophylactic mesh at stoma formation can reduce PSH rates. The aim of this study was to systematically review use of prophylactic mesh versus no mesh with regard to occurrence of PSH and peristomal complications. METHODS A systematic search was performed using PubMed, Embase™ and the Cochrane Library to identify randomised controlled trials that analysed placement of prophylactic mesh versus no mesh at time of initial surgery. Meta-analysis was performed using random effects methods. RESULTS A total of 506 studies were identified by our search strategy. Of these, 8 studies were included, involving 430 patients (217 mesh vs 213 no mesh). Prophylactic mesh placement resulted in a significantly lower rate of PSH formation (42/217 [19.4%] vs 92/213 [43.2%]) with a combined risk ratio of 0.40 (95% confidence interval [CI]: 0.21-0.75, p=0.004). Placement of prophylactic mesh did not result in increased peristomal complications (15/218 [6.9%] vs 16/227 [7.0%]) with a combined risk ratio of 1.0 (95% CI: 0.49-2.01, p=0.990). CONCLUSIONS Prophylactic placement of mesh at primary stoma formation may reduce the incidence of PSH, without an increase in peristomal complications. However, the overall quality of the randomised controlled trials included in the meta-analysis was poor, and should prompt caution regarding the applicability of the findings of the individual studies and the meta-analysis to everyday practice.en
dc.languageENG
dc.language.isoenen
dc.publisherRoyal College of Surgeonsen
dc.relation.urlhttp://publishing.rcseng.ac.uk/doi/full/10.1308/rcsann.2016.0186en
dc.rightsArchived with thanks to Annals of the Royal College of Surgeons of Englanden
dc.subjectWessex Classification Subject Headings::Gastroenterologyen
dc.titleProphylactic mesh use during primary stoma formation to prevent parastomal hernia.en
dc.typeJournal Articleen
dc.typeMeta-Analysisen
dc.identifier.journalAnnals of the Royal College of Surgeons of Englanden
dc.description.noteThis article is currently freely available via the publisher's website. Click on 'Additional Link' above to access the full-text via the publisher's site.en
dc.type.versionIn press (epub ahead of print)en


Files in this item

FilesSizeFormatView

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record