Comparative Study between Constructing Permanent End Colostomy with Prophylactic Mesh VS Constructing Colostomy without Prophylactic Mesh for the Incidence of Parastomal Hernia: A Systematic Review and Meta-Analysis

Background: Colostomy construction techniques have evolved over the last 2 centuries to improve function and reduce stoma complications. The relationship between the technique of colostomy construction and the riskof postoperative parastomal hernia formation is still unclear. Aim of Study: Evaluation of the PSH rate in constructing colostomy with or without prophylactic surgical mesh. Patients and Methods: This systematic review and meta-analysis study included thirteen studies with a total of 1287 cases; 601 cases in patient treated with mesh group and 686 cases in patient treated without mesh group to evaluate the PSH rate in constructing colostomy with or without prophylactic surgical mesh. Results: There was no significant difference between both groups in the surgery duration, length of hospital stay. None of the studies reported death of any cases in both groups. Both groups performed equally with no statistically significant difference. There was no significant difference between both groups in the size of stoma orifice. Patient who underwent permanent end colostomy with prophylactic Mesh had significant reduction in rates parastomal hernia than those who underwent colostomy without prophylactic mesh. Conclusion: The operative time and length of hospital stay were comparable between the studied groups. Both constructing permanent end colostomy with and without prophylactic mesh showed no risk of mortality. Both procedures showed comparable risk of postoperative morbidity. Prophylactic placement of mesh at stoma formation reduced the incidence of PSH, without an increase in stomal complications.