Use of a Prosthetic Mesh for Prevention of Parastomal Hernia
European guidelines currently recommend the use of a mesh at the time of a stoma formation for the prevention of Parastomal Hernia (PSH). More recently 2 large RCTs found no benefit in the mesh group.

Researchers investigated whether these latest results could change the conclusion of a meta-analysis. The primary endpoint of this meta-analysis was the PSH rate at 1 year of follow-up with or without the use of a mesh. The study was published in the Annals of Surgery.

Researchers conducted a comprehensive literature search and analyzed RCT investigating the use of a mesh to prevent PSH formation. All studies including end colostomies were included in the qualitative analysis no matter the surgical technique or the type of mesh. All studies with a limited risk of bias and presenting usable data were used in the quantitative analysis.

- There is a large heterogeneity among the studies, in terms of the position of the mesh, surgical technique, and diagnostic method for the PSH.

- No statistically significant difference was found in the PSH rate at 1 or 2 years between the mesh and non-mesh groups.

Based on this meta-analysis including the latest RCT on the prevention of PSH, the use of a mesh should not be recommended.

Source: https://journals.lww.com/annalsofsurgery/Abstract/2021/07000/Meta_analysis_and_Systematic_Review_of_the_Use_of.6.aspx
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