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. 2011 Jul;15(7):1252-8.
doi: 10.1007/s11605-011-1435-8. Epub 2011 Mar 1.

Repair of parastomal hernias with biologic grafts: a systematic review

Nicholas Jonathan Slater  1 , Bibi M E Hansson, Otmar R Buyne, Thijs Hendriks, Robert P Bleichrodt
Affiliations

Repair of parastomal hernias with biologic grafts: a systematic review

Nicholas Jonathan Slater et al. J Gastrointest Surg. 2011 Jul.

Abstract

Background: Biologic grafts are increasingly used instead of synthetic mesh for parastomal hernia repair due to concerns of synthetic mesh-related complications. This systematic review was designed to evaluate the use of these collagen-based scaffolds for the repair of parastomal hernias.

Methods: Studies were retrieved after searching the electronic databases MEDLINE, EMBASE and Cochrane CENTRAL. The search terms 'paracolostomy', 'paraileostomy', 'parastomal', 'colostomy', 'ileostomy', 'hernia', 'defect', 'closure', 'repair' and 'reconstruction' were used. Selection of studies and assessment of methodological quality were performed with a modified MINORS index. All reports on repair of parastomal hernias using a collagen-based biologic scaffold to reinforce or bridge the defect were included. Outcomes were recurrence rate, mortality and morbidity.

Results: Four retrospective studies with a combined enrolment of 57 patients were included. Recurrence occurred in 15.7% (95% confidence interval [CI] 7.8-25.9) of patients and wound-related complications in 26.2% (95% CI 14.7-39.5). No mortality or graft infections were reported.

Conclusions: The use of reinforcing or bridging biologic grafts during parastomal hernia repair results in acceptable rates of recurrence and complications. However, given the similar rates of recurrence and complications achieved using synthetic mesh in this scenario, the evidence does not support use of biologic grafts.

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Figures

Fig. 1
Fig. 1
Flowchart of search strategy
Fig. 2
Fig. 2
Weighted pooled proportion (fixed-effects model; Cochran’s Q = 1.917, p = 0.5899) of recurrences after parastomal hernia repair using biologic grafts
See this image and copyright information in PMC

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