Peer-reviewed veterinary case report
Mesh at stoma reversal cuts hernia risk without more complications
By Gosavi R et al.·2026·Department of Colorectal Surgery, Australia·View original on Europe PMC →
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Original publication title: Prophylactic mesh at stoma reversal reduces incisional hernia without increasing early complications: a systematic review and meta-analysis of randomised trials.
Plain-English summary
After surgery to reverse a stoma (an opening created for waste removal), some patients can develop incisional hernias at the site. A review of studies found that using a special mesh during the closure can significantly lower the chances of these hernias developing within a year, without increasing the risk of early complications like infections or leaks. While the surgery took a bit longer when the mesh was used, the overall benefits, especially for patients at higher risk, suggest that this method is worth considering. The treatment was effective in reducing hernia rates, and no serious issues related to the mesh were reported.
Abstract
<h4>Background</h4>Stoma-site incisional hernias (SSIHs) are a common complication following ileostomy or colostomy reversal. Prophylactic mesh placement during stoma closure may reduce this risk, but adoption is limited by concerns regarding mesh safety and uncertainty regarding long-term benefit.<h4>Methods</h4>We conducted a systematic review and meta-analysis of randomised controlled trials comparing prophylactic mesh with standard fascial closure during elective stoma reversal. The primary outcome was SSIH within 12 months. Secondary outcomes included surgical-site infection (SSI), mesh-related complications, anastomotic leak, operative time, and patient-reported outcomes. Risk of bias was assessed using ROB 2.0, and certainty of evidence was evaluated using GRADE.<h4>Results</h4>Three RCTs comprising 957 patients (mesh: n = 477; control: n = 480) were included. Prophylactic mesh significantly reduced SSIH at 12 months (risk ratio 0.25, 95% CI 0.08-0.76), with an absolute risk reduction of 13.6%. SSI (OR 1.21, 95% CI 0.84-1.74) and anastomotic leak (OR 1.08, 95% CI 0.50-2.33) did not differ significantly between groups. Operative time was longer in the mesh group (mean difference + 25.25 min, 95% CI 15.83-34.68). Mesh-related complications were rare, and no explantations occurred. Two trials reported improved hernia-specific quality of life with mesh.<h4>Conclusion</h4>Prophylactic mesh during elective stoma closure significantly reduces SSIH without increasing early complications. While operative time is modestly increased, the clinical benefit and safety profile support routine consideration of mesh, particularly in high-risk patients. Longer-term follow-up and cost-effectiveness data are needed to guide broader implementation.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41618036