AimTemporary stoma formation remains a common part of modern‐day colorectal surgical operations. At the time of reversal, a second procedure is required when the bowel is anastomosed and the musculature is closed. The rate of incisional hernia at these sites is 30%–35% with conventional suture closure. Mesh placement at this site is therefore an attractive option to reduce hernia risk, particularly as new mesh types, such as biosynthetic meshes, are available. The aim of this work was to conduct a systematic review and meta‐analysis assessing the use of mesh for prophylaxis of incisional hernia at stoma closure and to explore the outcome measures used by each of the included studies to establish whether they are genuinely patient‐centred.MethodThis is a systematic review and meta‐analysis assessing the published literature regarding the use of mesh at stoma site closure operations. Comprehensive literature searches of major electronic databases were performed by an information specialist. Screening of search results was undertaken using standard systematic review principles. Data from selected studies were input into an Excel file. Meta‐analysis of the results of included studies was conducted using RevMan software (v.5.4). Randomized controlled trial (RCT) and non‐RCT data were analysed separately.ResultsEleven studies with a total of 2008 patients were selected for inclusion, with various mesh types used. Of the included studies, one was a RCT, seven were nonrandomized comparative studies and three were case series. The meta‐analysis of nonrandomized studies shows that the rate of incisional hernia was lower in the mesh reinforcement group compared with the suture closure group (OR 0.21, 95% CI 0.12–0.37) while rates of infection and haematoma/seroma were similar between groups (OR 0.7, 95% CI 0.41–1.21 and OR 1.05, 95% CI 0.63–1.80, respectively). The results of the RCT were in line with those of the nonrandomized studies.ConclusionCurrent evidence indicates that mesh is safe and reduces incisional hernia. However, this is not commonly adopted into current clinical practice and the literature has minimal patient‐reported outcome measures. Future work should explore the reasons for such slow adoption as well as the preferences of patients in terms of outcome measures that matter most to them.

中文翻译：

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用生物合成网状筋膜加固逆转造口：系统评价和荟萃分析

目的临时造口形成仍然是现代结直肠外科手术的常见部分。在逆转时，当肠吻合且肌肉组织闭合时，需要进行第二次手术。使用传统缝线闭合时，这些部位的切口疝发生率为 30%–35%。因此，在该部位放置网片是降低疝气风险的一个有吸引力的选择，特别是当新的网片类型（例如生物合成网片）可用时。这项工作的目的是进行系统回顾和荟萃分析，评估网片在造口闭合时预防切口疝的用途，并探讨每项纳入研究使用的结果指标，以确定它们是否真正以患者为中心方法这是一项系统回顾和荟萃分析，评估了有关在造口部位闭合手术中使用网片的已发表文献。由信息专家对主要电子数据库进行了全面的文献检索。使用标准系统审查原则对检索结果进行筛选。所选研究的数据被输入到 Excel 文件中。使用 RevMan 软件（v.5.4）对纳入研究的结果进行荟萃分析。随机对照试验（RCT）和非 RCT 数据分别进行分析。结果 选择纳入 11 项研究，共 2008 名患者，使用了不同的网格类型。在纳入的研究中，一项是随机对照研究，七项是非随机比较研究，三项是病例系列研究。非随机研究的荟萃分析显示，与缝合闭合组相比，补片组的切口疝发生率较低（OR 0.21，95% CI 0.12–0.37），而组间感染和血肿/血清发生率相似（分别为 OR 0.7、95% CI 0.41–1.21 和 OR 1.05、95% CI 0.63–1.80）。随机对照试验的结果与非随机研究的结果一致。结论当前证据表明补片是安全的并且可以减少切口疝。然而，这在当前的临床实践中并不普遍采用，并且文献中患者报告的结果测量也很少。未来的工作应该探讨采用速度如此缓慢的原因以及患者对对他们最重要的结果指标的偏好。