• Michel Prudhomme, Pascale Fabbro-Peray, Eric Rullier, Bob V Occean, and Martin M Bertrand.
• Department of Digestive Surgery, CHU Nimes, Univ Montpellier, Nimes, France.
• Ann. Surg. 2021 Jul 1; 274 (1): 202820-28.

ObjectiveThe primary endpoint of this meta-analysis was the PSH rate at 1 year of follow-up with or without the use of a mesh.Summary Of Background DataEuropean guidelines currently recommend the use of a mesh at the time of a stoma formation for the prevention of PSH. These recommendations are based on the RCT and meta-analyses published before 2017. More recently 2 large RCT found no benefit in the mesh group. We investigated whether these latest results could change the conclusion of a meta-analysis.MethodsWe 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 with usable data were used in the quantitative analysis.ResultsThere is a large heterogeneity among the studies, in terms of position of the mesh, surgical technique, and diagnostic method for the PSH.No statistically significant difference was found on the PSH rate at 1 or 2 years between the mesh and non-mesh groups.ConclusionsBased on this meta-analysis including the latest RCT on the prevention of PSH, the use of a mesh should not be recommended.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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