PDF(Pubmed)
Abstract：
Background: Parastomal hernia presents frequently after construction of a permanent end colostomy. Previous guidelines recommend using a prophylactic mesh for hernia prevention. Randomized controlled trials (RCTs) published hereafter demonstrate conflicting outcomes. Methods and Analysis: A rapid guideline will be developed and reported in accordance with GRADE, GIN and AGREE-S standards. The steering group will consist of general and colorectal surgeons, members of the EHS Scientific Advisory Board with expertise and experience in guideline development, advanced medical statistics and evidence synthesis, and a certified guideline methodologist. The guideline panel will consist of three general surgeons, three colorectal surgeons, two stoma care nurses, and two patient representatives. A single question will address the safety and efficacy of the use of a prophylactic mesh in patients with a permanent end colostomy, and sensitivity analyses will focus on the use of non-absorbable versus absorbable meshes, and on different anatomical spaces for mesh placement. A systematic review will be conducted and evidence synthesis will be performed by statisticians independently. The results of evidence synthesis will be summarized in summary of findings tables. Recommendation(s) will be finalized through Delphi process of the guideline panel within an evidence-to-decision framework. Ethics and Dissemination: The funding body will not be involved in the development of this guideline. Conflicts of interest, if any, will be addressed by re-assigning functions or replacing participants with direct conflicts, according to Guidelines International Network recommendations.
摘要：
背景：造口旁疝在永久性结肠造口术后经常出现。以前的指南建议使用预防性网片预防疝气。此后发表的随机对照试验(RCTs)显示结果相互矛盾。方法和分析：将根据GRADE制定和报告快速指南，GIN和AGREE-S标准。指导小组将由普通和结直肠外科医生组成，EHS科学顾问委员会成员，在指南制定方面具有专业知识和经验，先进的医学统计和证据综合，和经过认证的指导方法学家。指引小组将由三名普通外科医生组成，三个结直肠外科医生,两名造口护理护士,和两名患者代表。一个问题将解决永久性结肠造口术患者使用预防性网状物的安全性和有效性，和敏感性分析将集中在使用不可吸收的网格和可吸收的网格，并在不同的解剖空间上进行网格放置。将进行系统审查，并由统计学家独立进行证据综合。证据综合的结果将总结在结果表摘要中。建议将在证据到决策框架内通过指南小组的Delphi过程最终确定。伦理和传播：资助机构将不参与本指南的制定。利益冲突,如果有的话,将通过重新分配职能或替换具有直接冲突的参与者来解决，根据国际网络指南的建议。
