Synthetic vs biologic mesh for the repair and prevention of parastomal hernia

Table 6 Study characteristics and outcomes of prophylactic mesh placement of parastomal hernia n (%)

Ref.	No. Patients (completed follow-up)		Type of stoma	Material; technique	Parastomal hernia1		Wound infection		Mesh infection	Other3		Mor-tality	Follow-up (mo)
	Mesh	No mesh			Mesh	No mesh	Mesh	No mesh	Mesh	Mesh	No mesh
Târcoveanu et al[44]	20	22	C: 42	O: 42; Sublay; PP	0	6 (27)	0	2 (9)	0	9 (45)	11 (50)	0	9 (median)
Ventham et al[63]	17	24	C: 42	O: 42; Sublay; PP	6 (35)	13 (54)	2 (12%)	1 (4)	NS	0	0	0	12
López-Cano et al[40]	19 (18)	17 (16)	C: 36	L: 36; IPOM; SB; Proceed	9 (50)	15 (94)	8 (44)	3 (19)	0	16 (89)	5 (31)	12 (3)	12
Hauters et al[16]	20	-	C: 20	L: 17 O: 3; IPOM; SB: 20; PCM	1 (5)	-	0	-	0	6 (30)	-	0	24
Figel et al[62]	16	-	C: 16	O: 16; IPOM; SB: 12; K: 4; Surgisis	0	-	0	-	0	NS	-	0	38 (median)
Janson et al[64]	25	-	C: 25	L: 25; Sublay; ULTRAPRO	3 (15)	-	2 (8)	-	0	1 (4)	-	0	19
Jänes et al[42]	75 (61)	18 (12)	C: 79 I: 14	O: 93; Sublay; ULTRAPRO	8 (13)	8 (67)	6 (8)	4 (22)	0	0	0	52 (5)	15
Serra-Aracil et al[6]	27	27	C: 54	O: 54; Sublay; ULTRAPRO	6 (22)	12 (44)	4 (15)	4 (15)	0	1 (4)	1 (4)	0	29
Vijayasekar et al[45]	42	-	C: 33 I: 9	O: 42; Sublay; PP	4 (10)	-	1 (2)	-	0	1 (2)	-	0	31
Jänes et al[43]	27 (15)	27 (21)	C:54	O: 54; Sublay; Vypro	2 (13)	17 (81)	0	0	0	0	0	0	65
Hammond et al[68]	10	10	NS	O: 20; Sublay; Permacol	0	3 (30)	0	0	0	0	0	0	6.5
Hammond et al[21]	15	-	NS	O: 15; Onlay: 6; Sublay 9; Permacol	1 (7)	-	NS	-	NS	NS	-	0	7 (median)
Berger[39]	25 (24)	-	C: 24 I: 1	L: 6, O: 19; IPOM; K; DynaMesh	0	-	0	-	0	0	-	12 (4)	11
Marimuthu et al[46]	18	-	NS	O: 18; Sublay; Surgipro	0	-	1 (6)	-	0	1 (6)	-	0	16
Gögenur et al[22]	25 (24)	-	C: 25	O: 25; Sublay; StomaMesh	2 (8)	-	4 (17)	-	0	6 (25)	-	12 (4)	12
Vierimaa et al[23]	42 (35)	41 (32)	C: 83	L: 83; IPOM; K; DynaMesh	5 (14)	12 (38)	1 (3)	2 (6)	NS	9 (21)	10 (24)	12 (1)	12
Fleshman et al[20]	55 (49)	58 (53)	C: I:23/ C:35 I: I:19/ C:36	O: 113; Sublay; STRATTICE	6 (12)	7 (136)	2 (4)	3 (6)	0	21 (38)	30 (52)	112 (10)	24
Williams et al[41]	22 (21)	11	C: I:4/ C:7 I: I:11/ C:11	I: O = 18 L = 4 C: O = 11 SMART Onlay; Permacol	4 (19)	8 (73)	NS	NS	0	2 (9)	0	12 (3)	I: 18 C: 9
Weighted pooled %; (95%CI)					11.5% (7.1-16.8)	51.5% (33.7-69.1)	6.90% (3.6-11.1)	9.30% (4.8-15.1)	0% (0-2.0) FE	14.20% (5.5-26.0)	13.80% (3.0-30.7)	2.6% (1.3-4.4)

¹With regard to lost after follow-up;

²Unrelated to mesh;

³Seroma 9 (10); Cardiopulmonary event 6 (10, 436); Urinary tract infection 7 (10, 436); Cutaneous/fascial dehiscence 5 (53, 231,436); Stoma (mucosal/intestinal) necrosis 16 (53, 126, 163, 173, 227,436); Intra-abdominal/pelvic infection 2 (436, 489); Intestinal occlusion 4 (436,489); Stoma-related problems 2 (436); Other 27 (10, 53, 54, 231); Severe events not further specified 51 (488). L: Laparoscopic; O: Open; C: Colostomy; I: Ileostomy; SB: Sugarbaker; PP: Polypropylene mesh; IPOM: Intraperitoneal mesh; PCM: Parietex composite mesh; SMART: Stapled mesh stoma reinforcement technique.