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Background <p>Parastomal hernia is a&#xa0;common complication after colostomy, especially end colostomy. It is unclear whether prophylactic placement of a&#xa0;three-dimensional mesh at the time of stoma formation could prevent parastomal hernia formation after surgery for rectal cancer.</p> Methods <p>A&#xa0;systematic review was undertaken to evaluate the efficacy of prophylactic mesh placement in end colostomy construction from 2000 to 2025 using MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trails, and Clinical trials including CT.gov. The gray literature was searched, including reference lists of included studies and clinical practice guidelines. Observational studies were also included due to the scarcity of randomized controlled trials (RCTs) on this topic. The primary outcome of the study was the incidence of parastomal hernia.</p> Results <p>Five observational studies and two RCTs were included, comprising 512 patients across the seven selected studies. Parastomal hernia occurred in 10.2% (32/313) of patients with mesh and 50.7% (97/191) of patients without mesh. Thematic analysis identified four overarching themes that could have influenced the efficacy of three-dimensional mesh placement: (1)&#xa0;follow-ups and parastomal hernia, (2)&#xa0;postoperative complications, (3)&#xa0;surgical technique, and (4)&#xa0;demographic make-up.</p> Conclusion <p>Prophylactic placement of a&#xa0;three-dimensional mesh at the time of stoma formation is associated with a&#xa0;significant reduction in the incidence of parastomal hernia. However, findings need to be interpreted with caution due to the heterogeneity of the studies retrieved regarding clinical and non-clinical parameters. The variability in the diagnosis of parastomal hernia, surgical techniques, sample characteristics (age, gender, and medical history), and methodology (follow-up time) limits comparisons of the results.</p>

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Effectiveness of prophylactic three-dimensional mesh in preventing parastomal hernia in patients undergoing permanent end colostomy formation for rectal cancer: a systematic review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月27日

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  • Anies Sebastian,
  • Felicity Hasson,
  • Sinead Keeney

摘要

Background

Parastomal hernia is a common complication after colostomy, especially end colostomy. It is unclear whether prophylactic placement of a three-dimensional mesh at the time of stoma formation could prevent parastomal hernia formation after surgery for rectal cancer.

Methods

A systematic review was undertaken to evaluate the efficacy of prophylactic mesh placement in end colostomy construction from 2000 to 2025 using MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trails, and Clinical trials including CT.gov. The gray literature was searched, including reference lists of included studies and clinical practice guidelines. Observational studies were also included due to the scarcity of randomized controlled trials (RCTs) on this topic. The primary outcome of the study was the incidence of parastomal hernia.

Results

Five observational studies and two RCTs were included, comprising 512 patients across the seven selected studies. Parastomal hernia occurred in 10.2% (32/313) of patients with mesh and 50.7% (97/191) of patients without mesh. Thematic analysis identified four overarching themes that could have influenced the efficacy of three-dimensional mesh placement: (1) follow-ups and parastomal hernia, (2) postoperative complications, (3) surgical technique, and (4) demographic make-up.

Conclusion

Prophylactic placement of a three-dimensional mesh at the time of stoma formation is associated with a significant reduction in the incidence of parastomal hernia. However, findings need to be interpreted with caution due to the heterogeneity of the studies retrieved regarding clinical and non-clinical parameters. The variability in the diagnosis of parastomal hernia, surgical techniques, sample characteristics (age, gender, and medical history), and methodology (follow-up time) limits comparisons of the results.