Meta-analysis of prophylactic mesh to prevent parastomal hernia
| العنوان: | Meta-analysis of prophylactic mesh to prevent parastomal hernia |
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| المؤلفون: | Andrea J. Cross, Tim Eglinton, Frank A. Frizelle, Pamela Buchwald |
| المصدر: | British Journal of Surgery. 104:179-186 |
| بيانات النشر: | Oxford University Press (OUP), 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | medicine.medical_specialty, Ostomy, MEDLINE, 030230 surgery, law.invention, Stoma, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, medicine, Humans, Incisional Hernia, Herniorrhaphy, Randomized Controlled Trials as Topic, Models, Statistical, business.industry, Surgical Stomas, Odds ratio, Surgical Mesh, Surgery, Clinical trial, Treatment Outcome, Surgical mesh, Systematic review, 030220 oncology & carcinogenesis, Meta-analysis, business |
| الوصف: | Background Rates of parastomal hernia following stoma formation remain high. Previous systematic reviews suggested that prophylactic mesh reduces the rate of parastomal hernia; however, a larger trial has recently called this into question. The aim was to determine whether mesh placed at the time of primary stoma creation prevents parastomal hernia. Methods The Cochrane Central Register of Controlled Trials, MEDLINE, Embase and CINAHL were searched using medical subject headings for parastomal hernia, mesh and prevention. Reference lists of identified studies, clinicaltrials.gov and the WHO International Clinical Trials Registry were also searched. All randomized clinical trials were included. Two authors extracted data from each study independently using a purpose-designed sheet. Risk of bias was assessed by a tool based on that developed by Cochrane. Results Ten randomized trials were identified among 150 studies screened. In total 649 patients were included in the analysis (324 received mesh). Overall the rates of parastomal hernia were 53 of 324 (16·4 per cent) in the mesh group and 119 of 325 (36·6 per cent) in the non-mesh group (odds ratio 0·24, 95 per cent c.i. 0·12 to 0·50; P < 0·001). Mesh reduced the rate of parastomal hernia repair by 65 (95 per cent c.i. 28 to 85) per cent (P = 0·02). There were no differences in rates of parastomal infection, stomal stenosis or necrosis. Mesh type and position, and study quality did not have an independent effect on this relationship. Conclusion Mesh placed prophylactically at the time of stoma creation reduced the rate of parastomal hernia, without an increase in mesh-related complications. |
| تدمد: | 1365-2168 0007-1323 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::604e4e3062a65dc0a297f1c52cfe0bcbTest https://doi.org/10.1002/bjs.10402Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....604e4e3062a65dc0a297f1c52cfe0bcb |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13652168 00071323 |
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