Systematic review and meta-analysis of postoperative outcomes after combined stoma reversal and incisional hernia repair versus stoma reversal alone.
Minerva Surg
; 79(3): 339-345, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38298121
ABSTRACT
BACKGROUND:
The optimal management and timing of the abdominal wall reconstruction concomitantly performed with stoma closure are controversial. This study aims to compare short-term postoperative outcomes after concurrent stoma reversal (SR) with incisional hernia repair (IHR) and SR alone.METHODS:
PubMed/MEDLINE, Scopus and Web of Science databases were consulted to identify comparative studies. Random and common-effect models were used for the pooled analysis of the proportions and means.RESULTS:
Three studies met the inclusion criteria and a total of 504 patients who underwent simultaneous SR and IHR (N.=200) or SR alone (N.=304) were included in the meta-analysis. Postoperative morbidity increased after combined stoma and hernia surgery with a pooled OR for Surgical Site Occurrence (SSO) and severe postoperative complications (Clavien-Dindo ≥III) of 1.72 (95% CI 1.02-2.90) and 3.83 (95% CI 1.46-10.02), respectively. No significant difference was found between the two groups in terms of mortality (OR 1.66; 95% CI 0.64-4.27), length of hospital stay (OR 1.37; 95% CI 0.73-3.47). and readmission rate (OR 1.17; 95% CI 0.67-2.06).CONCLUSIONS:
There is limited evidence suggesting that synchronous repair of SR and IH appears to be associated with a higher risk of SSO and severe postoperative complications. Therefore, a stepwise approach may be considered the best strategy in this setting.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Estomas Cirúrgicos
/
Herniorrafia
/
Hérnia Incisional
Tipo de estudo:
Prognostic_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Minerva Surg
Ano de publicação:
2024
Tipo de documento:
Article