PDF(Pubmed)
Abstract：
UNASSIGNED: Many abdominal-pelvic surgeries utilize incisions not along the linea alba, such as transverse, laparoscopic, ostomy reversal, or ostomy formation incisions. The prevalence of ventral incisional hernias (VIH) at these sites and the efficacy of prophylactic mesh in preventing VIH remains unclear.
UNASSIGNED: PubMed, Embase, Scopus, and Cochrane databases were systematically reviewed from inception to September 2022. We included published randomized controlled trials (RCTs) that compared prophylactic mesh reinforcement versus no mesh. The primary outcome was the incidence of VIH at postoperative follow-up equal to or greater than 24 months. Secondary outcomes included surgical site infection (SSI) and surgical site occurrence (SSO).
UNASSIGNED: Of 3186 screened articles, only 3 RCTs with at least an 80% 2-year follow-up, encompassing a total of 901 patients, were included for analysis of non-midline VIH. Fifteen additional RCTs were included for analysis of secondary outcomes. The rate of parastomal hernias with prophylactic mesh was 21%, while it ranged from 44%-64% in the control group. The rate of incisional hernia after ostomy reversal with prophylactic mesh was 10%, and 16% in the control group. No clear evidence of a difference was found in rates of SSI or SSO between groups.
UNASSIGNED: There is limited evidence on the role of prophylactic mesh in preventing non-midline VIH. More studies at low risk for bias are needed to elucidate the balance of the long-term risks and benefits of prophylactic mesh for non-midline incisions.
UNASSIGNED: PubMed, Embase, Scopus, and Cochrane databases were systematically reviewed from inception to September 2022. We included published randomized controlled trials (RCTs) that compared prophylactic mesh reinforcement versus no mesh. The primary outcome was the incidence of VIH at postoperative follow-up equal to or greater than 24 months. Secondary outcomes included surgical site infection (SSI) and surgical site occurrence (SSO).
UNASSIGNED: Of 3186 screened articles, only 3 RCTs with at least an 80% 2-year follow-up, encompassing a total of 901 patients, were included for analysis of non-midline VIH. Fifteen additional RCTs were included for analysis of secondary outcomes. The rate of parastomal hernias with prophylactic mesh was 21%, while it ranged from 44%-64% in the control group. The rate of incisional hernia after ostomy reversal with prophylactic mesh was 10%, and 16% in the control group. No clear evidence of a difference was found in rates of SSI or SSO between groups.
UNASSIGNED: There is limited evidence on the role of prophylactic mesh in preventing non-midline VIH. More studies at low risk for bias are needed to elucidate the balance of the long-term risks and benefits of prophylactic mesh for non-midline incisions.
摘要：
■许多腹部-骨盆手术使用不沿着白线的切口，如横向，腹腔镜,造口术逆转,或造口术形成切口。腹侧切口疝（VIH）在这些部位的患病率以及预防性网片预防VIH的疗效尚不清楚。
■PubMed,Embase,Scopus,和Cochrane数据库从开始到2022年9月进行了系统审查。我们纳入了已发表的随机对照试验（RCT），比较了预防性网状物加固与无网状物。主要结果是术后随访等于或大于24个月时VIH的发生率。次要结果包括手术部位感染（SSI）和手术部位发生（SSO）。
■在3186篇筛选的文章中，只有3个RCT至少有80%的2年随访，共有901名患者，纳入非中线VIH分析。另外15个RCT纳入次要结局分析。预防性网片的造口旁疝发生率为21%，而对照组为44%-64%。预防性网片造口术后切口疝的发生率为10%，对照组为16%。没有明确的证据表明两组之间的SSI或SSO发生率存在差异。
■关于预防性网状物在预防非中线VIH中的作用的证据有限。需要更多低偏倚风险的研究来阐明非中线切口预防性网状物的长期风险和益处的平衡。
■PubMed,Embase,Scopus,和Cochrane数据库从开始到2022年9月进行了系统审查。我们纳入了已发表的随机对照试验（RCT），比较了预防性网状物加固与无网状物。主要结果是术后随访等于或大于24个月时VIH的发生率。次要结果包括手术部位感染（SSI）和手术部位发生（SSO）。
■在3186篇筛选的文章中，只有3个RCT至少有80%的2年随访，共有901名患者，纳入非中线VIH分析。另外15个RCT纳入次要结局分析。预防性网片的造口旁疝发生率为21%，而对照组为44%-64%。预防性网片造口术后切口疝的发生率为10%，对照组为16%。没有明确的证据表明两组之间的SSI或SSO发生率存在差异。
■关于预防性网状物在预防非中线VIH中的作用的证据有限。需要更多低偏倚风险的研究来阐明非中线切口预防性网状物的长期风险和益处的平衡。
