Review question

This review looked at whether placing a mesh (foreign material) around a stoma (a surgically created opening in the bowel and abdominal wall to allow the diversion of faeces) at the time of stoma formation affected whether study participants developed a hernia (a protrusion of the abdominal contents through a weakness within the abdominal wall) around the stoma. We also aimed to judge whether there were any risks or complications associated with mesh placement compared to no mesh.

Background

Hernia formation around a stoma affects up to 50% of people undergoing formation of a stoma. The hernia might enlarge over time, which can cause considerable patient discomfort which in turn may lead patients to restrict their work and other physical activities. Reoperation and cosmetic concerns may also arise.

Study characteristics

Following our data search in January 2018, we included 10 trials with a total of 844 participants, which we assessed using the standard Cochrane Review protocol. The trials compared the incidence of hernia development around a stoma between a group having a mesh placement at the time of stoma formation and a control group having a conventional stoma formation without mesh placement.

Key results

We found that mesh placement around the stoma at the time of stoma formation reduces the incidence of future hernia formation. The participants having a mesh fitted had a similar level of complications as those not having a mesh.

Quality of evidence

We found low-quality evidence favouring the insertion of a mesh into people having a stoma.