Systematic Reviews
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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Dec 26, 2017; 5(6): 150-166
Published online Dec 26, 2017. doi: 10.13105/wjma.v5.i6.150
Table 1 Patient demographics, study characteristics and critical appraisal of included studies
Ref .Year Inclusion period Level of evidence Mean age, years Male (%) Newcastle-Ottawa Scale Cochrane risk of bias Târcoveanu et al [44 ] 2014 2010-2011 1 NS NS ? ? - - + - ? Ventham et al [63 ] 2012 2003-2010 2 I: 69, C: 68 I: 42%, C: 35% **** ** *** Hansson et al [8 ] 2013 2005-2010 3 63 35% *** *** López-Cano et al [40 ] 2012 2007-2010 1 I: 72, C: 66 I: 58%, C: 42% + + - + + + + Hauters et al [16 ] 2012 2008-2010 3 69 (median) 40% *** *** Fei et al [34 ] 2012 2008-2010 3 63 45% *** *** Mizrahi et al [2 ] 2012 2005-2010 3 64 34% *** *** Wara et al [5 ] 2011 1997-2008 3 62 (median) 50% *** *** Janson et al [64 ] 2010 2003-2007 3 65 40% *** ** Jänes et al [42 ] 2010 2003-2006 2 63 66% **** ** Pastor et al [26 ] 2009 1999-2006 2 I: 60, C: 54 I: 42%, C: 54% **** * *** Lüning et al [65 ] 2009 1997-2006 3 65 27% *** ** Serra-Aracil et al [6 ] 2009 2004-2006 1 I: 68, C: 67 I: 70%, C: 59% ? + - + + + - Hansson et al [31 ] 2009 2002-2006 3 63 49% *** *** Vijayasekar et al [45 ] 2008 2002-2007 3 61 52% *** *** Jänes et al [43 ] 2009 2001-2003 1 I: 70, C: 71 I: 56%, C: 59% ? + - - + + - Berger et al [35 ] 2009 2004-2008 3 69 (median) NS *** *** Muysoms et al [27 ] 2008 2001-2007 2 70 54% **** * *** Guzmán-Valdivia et al [32 ] 2008 NS 3 67 64% *** ** Berger[39 ] 2008 2006-2007 3 72 (median) 64% *** ** Craft et al [66 ] 2008 2004-2006 3 66 NS *** *** Berger et al [7 ] 2007 1999-2006 3 70 (median) 39% *** *** Mancini et al [29 ] 2007 2001-2005 3 60 44% *** ** Marimuthu et al [46 ] 2006 2002-2005 3 67 44% *** ** Gögenur et al [22 ] 2006 2003-2005 3 71 (median) 60% *** ** van Sprundel et al [37 ] 2005 2000-2003 3 57 31% *** *** de Ruiter et al [33 ] 2005 1988-2002 3 NS NS *** *** Longman et al [67 ] 2005 2000-2004 3 NS NS *** ** LeBlanc et al [28 ] 2005 NS 3 42-89 NS *** *** Stelzner et al [36 ] 2004 1994-2002 3 70 (median) 60% *** ** Steele et al [30 ] 2003 1988-2002 3 64 50% *** *** Hofstetter et al [38 ] 1998 NS 3 NS NS *** *** Viermaa et al [23 ] 2015 2010-2013 1 I: 67 I: 51% + + - + + + + C: 65 C: 54% Asif et al [17 ] 2012 2004-2011 3 62 60% *** ** Figel et al [62 ] 2012 2005-2008 3 63 67% *** ** Smart et al [4 ] 2011 2007-2009 3 72 (median) 44% *** * Taner et al [25 ] 2009 2006-2007 3 NS 39% *** ** Hammond et al [68 ] 2008 NS 1 I: 43, C: 50 I: 30%, C: 40% ? + - - + + ? Hammond et al [21 ] 2008 NS 3 NS NS * Aycock et al [18 ] 2007 2004-2006 3 56 36% *** ** Araujo et al [24 ] 2005 3 57 27% *** *** Ellis et al [19 ] 2010 2004-2007 3 64 65% *** *** Fleshman et al [20 ] 2014 2010-2012 1 I: 60, C: 59 I: 55%, C: 50% + + - + + + - Williams et al [41 ] 2015 2011-? 2 I: 49, C: 59 I: 27%, C: 45% *** **
Table 2 Characteristics of synthetic and biologic prostheses used for parastomal hernia repair
Name Material Coating Absorbable Pore size Weight StomaMesh Surgipro Prolene Central ring enforced polypropylene Polypropylene None No Small to medium 0.8 mm or large 1.0-3.6 mm Heavy weight or light weight DUALMESH Composite multifilament expanded polytetrafluoroethylene None No Very small 3/22 µm Heavy weight Proceed Polypropylene Encapsulated in polydioxanone Oxidized regenerated cellulose Partially 180 d and 28 d Large Light weight Parietex Composite multifilament Polyester/collagen Type I collagen, polyethylene glycol, and glycerol layer Partially 20 d Large > 3 mm Medium weight ULTRAPRO Composite monofilament Polypropylene Poliglecaprone-25 (monocryl) Partially 140 d Large > 3 mm Light weight VICRYL Multifilament polyglactin None Yes, 60-90 d Small 0.4 mm Medium weight Vypro Polypropylene PG910 Partially 42 d Large > 3 mm Light weight Composix Parastomal hernia patch Polypropylene/expanded polytetrafluoroethylene None No Medium 0.8 mm Light weight DynaMesh Polypropylene PVDF Partially Large 1-2 mm Medium weight Surgisis Porcine small intestine submucosa None AlloDerm Human acellular dermis None Permacol Cross-linked acellular porcine collagen Yes, hexamethylene diisocyanate Peri-Guard Bovine pericardium Yes; glutaraldehyde STRATTICE Non-crosslinked porcine-derived acellular dermal matrix None
Table 3 Study characteristics and outcomes of synthetic mesh and biologic mesh repair of parastomal hernia n (%)
Ref .No. patients (completed follow-up) Type of stoma Material; technique Recurrence of parastomal hernia1 Wound infection Mesh infection Other3 Mortality Follow-up (mo) Mesh No mesh Mesh No mesh Mesh No mesh Mesh Mesh No mesh Hansson et al [8 ] 61 - C: 55 I: 4 U: 2 L: 55; IPOM: SB; ePTFE 4 (7) - 1 (2) - 1 (2) 21 (34) - 12 (2) 26 Fei et al [34 ] 11 - C: 6 I: 5 O: 11 Sublay: K; PP 1 (9) - 0 - NS 3 (27) - 0 24 Mizrahi et al [2 ] 29 (28) - C: 18 I: 10 U: 1 L: 29 IPOM: K; ePTFE 13 (46) - NS - 1 (4) 3 (11) - 12 (4) 28 Wara et al [5 ] 72 - C: 48 I: 24 L: 72 IPOM: K; PP+ePTFE 2 (3) - 1 (1) - 3 (4) 20 (28) - 22 (3) 36 Pastor et al [26 ] 12 13 C: 10 I: 15 L: 12 O: 13 IPOM: K 3 SB: 7, lateral slit: 1 e-PTFE 4 (33) 7 (54) 2 (17) 2 (15) 0 1 (8) 0 0 14 Lüning et al [65 ] 15 - C: 12 I: 3 O: 16 Onlay PP 7; PE 6; VICRYL 1; CRE-PPM 2 3 (20) - 0 - 1 (7) 1 (7) - NS 33 Hansson et al [31 ] 55 - C: 47 I: 5 U: 3 L 55 IPOM; K ePTFE 20 (36) - 0 - 2 (4) 29 (53) - 0 36 (median) Berger et al [35 ] 47 - NS L: 46 O: 1 Sandwich PVDF-PP 1 (2) - 1 (2) - NS 3 (6) - 0 20 (median) Muysoms et al [27 ] 24 - C:20 I: 4 L: 24 IPOM K:11 non-slit SB 13 Parietex 11; DUALMESH 10; Composix 3 10 (42) - NS - NS 2 (8) - 52 (21) K: 31 SB: 14 Guzmán-Valdivia et al [32 ] 25 - C:25 O: 25; Sublay PP 2 (8) - 2 (8) - 0 2 (8) - 0 12 Craft et al [66 ] 21 - C: 5 I: 7 U: 9 L: 21; IPOM K: 5 SB: 16 DUALMESH 1 (5) - 1 (5) - 2 (10) 8 (38) - 0 14 Berger et al [7 ] 66 - C:58 I:7 U:1 L: 66; IPOM SB: 41 Sandwich: 25 DUALMESH (until 4-2004) and Polyvinylidene 8 (12) - 1 (2) - 2 (3) 5 (8) - 0 24 (median) Mancini et al [29 ] 25 - C: 15 I: 5 U: 6 L: 25; IPOM SB DUALMESH 1 (4) - 1 (4) - 1 (4) 3 (12) - 12 (4) 19 (median) van Sprundel et al [37 ] 16 - C: 8 I: 5 U: 4 O: 16; IPOM K DUALMESH 1 (6) - 0 - 0 5 (31) - 0 29 (median) de Ruiter et al [33 ] 46 - C: 46 O: 46 Onlay CRE-PPM 7 (15) - 0 - 3 (7) 2 (4) - 0 51 Longman et al [67 ] 10 - C: 7 I: 3 O: 10 Sublay K PP 0 - 0 - 0 1 (10) - 0 30 (median) LeBlanc et al [28 ] 12 - C: 8 I: 2 U: 2 L: 12 IPOM SB 7, K 5 e-PTFE 1 (8) - 0 - 0 2 (17) - 12 (8) 20 Stelzner et al [36 ] 20 (19) - C: 20 O: 20 IPOM SB e-PTFE 3 (16) - 1 (5) - 0 3 (16) - 0 42 Steele et al [30 ] 58 - C: 31 I: 27 O: 58 Onlay “Stove pipe hat” PP 15 (26) - 2 (3) - 0 9 (16) - 0 51 Hofstetter et al [38 ] 13 - C: 13 O: 13 IPOM K e-PTFE 0 - 0 - 0 0 - 0 NS Asif et al [17 ] 33 C: 12 I: 21 L: 33 SB:14 K:19 DUALMESH 11 (33)4 - 4 (12) 0 9 (27) 0 SB: 7 K: 36 Weighted pooled % (95%CI) 15.1% (9.7-21.6) 2.8% (1.6-4.4) 3,1% (1.8-4.6) FE 17,8% (12.0-24.4) 1.9 (0.9-3.2) Smart et al [4 ] 27 - C: 20 I:7 O: 20 Onlay: K; Permacol 15 (55) - 1 (4) - 0 0 - 12 (4) 17 Taner et al [25 ] 13 - NS O: 13 Overlay + Underlay (sandwich) AlloDerm 2 (15) - 1 (8) - 0 4 (31%) - 0 10 Aycock et al [18 ] 11 - C:2 I:9 O: 11 Inlay 8; Onlay 3; AlloDerm 3 (27) - 2 (18) - NS 1 (9) - 0 9 Araujo et al [24 ] 13 - C: 13 O: 13 Onlay; Peri-Guard 1 (8) - 0 - NS NS - 0 50 Ellis[19 ] 20 - C: 17 I: 3 O: 20 IPOM; SB; Surgisis 2 (10) - 0 - 0 4 (20) - 0 18 Weighted pooled % (95%CI) 24% (8.6-44.1) 5.6% (1.4-12.1) 0% (0-5.4) FE 13.4% (1.9-32.7) 2.6% (0.3-6.9) FE
Table 4 Summary of pooled proportions of outcome measures of biologic mesh repair vs synthetic mesh repair
Hernia repair No of studies No of mesh repairs Recurrence Complications Wound infection Mesh infection Other Biologic mesh 5 84 24% (8.6-44.1) 5.6% (1.4-12.1) 0% (0-5.4) FE 13.4% (1.9-32.7) Synthetic mesh 21 669 15.1% (9.7-21.6) 2.8% (1.6-4.4) 3.1% (1.8-4.6) FE 17.8% (12.0-24.4) P value0.01 0.32 0.39 0.15
Table 5 Summary of pooled proportions of outcome measures of open synthetic mesh repair vs laparoscopic synthetic mesh repair
Hernia repair No. of studies No. of mesh repairs Recurrence Complications Wound infection Mesh infection Other Open repair 9 213 13.5% (8.1-20.2) 3% (1.2-5.7) FE 2.3% (0.7-4.8) FE 12.8% (7.4-19.4) Laparoscopic repair 10 397 18% (8.9-29.5) 2.4% (0.804.8) FE 3.6% (1.9-5.7) FE 23.8% (14.5-34.6) P value0.37 0.79 0.5 ≤ 0.0001
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)