Cochrane · systematic review · CD008905
Prosthetic mesh placement for the prevention of parastomal herniation
Jones, HG, Rees, M, Aboumarzouk, OM, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
ColorectalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
12
No studies
1
Included studies
NR
No studies 1 · 6.7%Ungraded 2 · 13.3%Very low 0 · 0%Low 8 · 53.3%Moderate 4 · 26.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Prosthetic mesh placement compared with standard treatment for the prevention of parastomal hernia
Population: individuals having a stoma formation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall incidence of parastomal hernia ( Prosthetic mesh placement vs standard treatment | RR 0.53 [0.43, 0.66] | 10 studies · 771 participants | Low Downgraded: risk of bias, inconsistency |
Reoperation rate ( Prosthetic mesh placement vs standard treatment | RR 0.9 [0.5, 1.64] | 9 studies · 757 participants | Low Downgraded: risk of bias, inconsistency |
Operative time for index procedure ( Prosthetic mesh placement vs standard treatment | no estimate extracted | 6 studies · 671 participants | Low Downgraded: inconsistency |
Postoperative length of stay ( Prosthetic mesh placement vs standard treatment | no estimate extracted | 4 studies · 500 participants | Moderate Downgraded: inconsistency |
Stoma‐related infection ( Prosthetic mesh placement vs standard treatment | RR 0.89 [0.32, 2.5] | 6 studies · 472 participants | Low Downgraded: risk of bias, inconsistency |
Mesh‐related infection ( Prosthetic mesh placement vs standard treatment | no estimate extracted | 4 studies · 128 participants | Ungraded |
Patient‐reported quality of life ( Prosthetic mesh placement vs standard treatment | no estimate extracted | 2 studies · 263 participants | Ungraded |
Rehospitalisations/ambulatory visits required for parastomal hernia problems/treatment ( Prosthetic mesh placement vs standard treatment | no estimate extracted | NR | No studies |
Prosthetic mesh placement compared with standard treatment for the prevention of parastomal hernia: subgroup and sensitivity analyses
Population: individuals having a stoma formation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subgroup analysis: Incidence of parastomal hernia at 12 months Prosthetic mesh placement vs standard treatment | RR 0.47 [0.29, 0.78] | 7 studies · 592 participants | Low Downgraded: risk of bias, inconsistency |
Subgroup analysis:Incidence of parastomal hernia (laparoscopic surgery) ( Prosthetic mesh placement vs standard treatment | RR 0.64 [0.47, 0.87] | 3 studies · 153 participants | Low Downgraded: risk of bias, inconsistency |
Subgroup analysis:Incidence of parastomal hernia (open surgery) ( Prosthetic mesh placement vs standard treatment | RR 0.46 [0.34, 0.62] | 6 studies · 517 participants | Moderate Downgraded: inconsistency |
Subgroup analysis:Incidence of parastomal hernia (sublay (extraperitoneal) mesh subgroup) ( Prosthetic mesh placement vs standard treatment | RR 0.48 [0.36, 0.64] | 7 studies · 619 participants | Moderate Downgraded: inconsistency |
Subgroup analysis:Incidence of parastomal hernia (intraperitoneal mesh subgroup) ( Prosthetic mesh placement vs standard treatment | RR 0.76 [0.55, 1.06] | 2 studies · 101 participants | Moderate Downgraded: inconsistency |
Incidence of parastomal hernia (worst‐case scenario sensitivity analysis) ( Prosthetic mesh placement vs standard treatment | RR 0.49 [0.3, 0.81] | 10 studies · 835 participants | Low Downgraded: risk of bias, inconsistency |
Incidence of parastomal hernia (best‐case scenario sensitivity analysis) ( Prosthetic mesh placement vs standard treatment | RR 0.4 [0.26, 0.61] | 10 studies · 835 participants | Low Downgraded: risk of bias, inconsistency |