Protocol for EHS Rapid Guideline: Parastomal hernia prevention

标题: Protocol for EHS Rapid Guideline: Parastomal hernia prevention
版本: 更新版
分类: 快速建议指南
领域: 治疗
国家和地区: 西班牙
指南使用者: General and colorectal surgeons, patients about to receive a permanent end colostomy
证据分级方法: GRADE
制定单位: European Hernia Society
注册时间: 2022-05-20
注册编号: IPGRP-2022CN216
指南制订的目的: Parastomal hernia is encountered frequently after permanent end colostomy. Previous systematic reviews suggest that the absolute risk of parastomal hernia is 30% by 12 months and 50% beyond 2 years. Using a prophylactic mesh, synthetic or absorbable, has been suggested to reduce the risk of parastomal hernia without increasing perioperative and longer-term stoma-related complications. Previous guidelines of the European Hernia Society provided a strong recommendation for the use of a prophylactic mesh when constructing an end colostomy. More recent data from randomized controlled trials (RCTs) provided conflicting evidence, giving rise to a debate over the optimum management of patients who are planned to have an end colostomy. In view of the new evidence and under consideration of the evolvement in the methodology of guideline development, the objective of this rapid guideline is to provide transparently developed, reliable, and evidence-informed update recommendation(s) on the use of prophylactic mesh for the prevention of parastomal hernia in patients who will have an end colostomy.