Abstract Aim The objective of this study was to systematically review and evaluate the effectiveness of mesh insertion at the stoma closure site in reducing the incidence of incisional hernia by analyzing published randomized and non-randomized studies. Methods Relevant studies were identified through searches of standard medical databases. The collected data was analyzed using the RevMan 5.4 statistical software to provide a pooled outcome. Results A total of two randomized controlled trials (RCTs) and five retrospective comparative studies involving 1955 patients who underwent stoma closure, with or without prophylactic mesh insertion, were included in the analysis. The mesh group included 766 patients, while 1189 patients were in the no-mesh group. The random-effects model analysis revealed that the incidence of incisional hernia was significantly lower in the mesh group compared to the no-mesh group (odds ratio 0.38, 95% CI 0.17–0.87, z = 2.29, p = 0.02). However, there was considerable heterogeneity among the included studies (Tau² = 0.87, Chi² = 23.68, df = 8, p = 0.003, I² = 66%).There were no significant differences between the two groups in terms of surgical site infections (odds ratio 0.84, 95% CI 0.48–1.50, z = 0.58, p = 0.56) seroma formation (odds ratio 0.96, 95% CI 0.61–1.50, z = 0.18, p = 0.86), or re-operation rates (odds ratio 0.37, 95% CI 0.09–1.49, z = 1.40, p = 0.16) Conclusion Prophylactic mesh insertion at the stoma closure site is associated with a reduced incidence of incisional hernia, demonstrating a clinically significant advantage.
Harvitkar et al. (Fri,) studied this question.