Introduction
The incidence of parastomal hernia exceeds 50% in the long term, with substantial implications on patients’ quality of life. Reinforcement of the stoma with a mesh has been suggested to be associated with lower incidence of parastomal hernia.
A previous guideline of the European Hernia Society (EHS) issued a strong recommendation for the use of a synthetic permanent prophylactic mesh in the construction of an end colostomy. This recommendation was primarily based upon evidence synthesis of randomized trials, suggesting a lower risk of parastomal hernia with the use of a prophylactic mesh without increasing perioperative and longer-term stoma-related complications.
The surgical literature has since seen a growing body of evidence on the use of synthetic permanent, absorbable, and biologic mesh for parastomal hernia prevention. In view of this new evidence and evolving methods in the field of clinical practice guidelines development, of an update of the guideline on parastomal hernias focused on prevention, and based upon an update systematic review, rigorous evidence appraisal, and a structured evidence-todecision framework informed by an international and interdisciplinary panel, including patient representatives. The objective is to inform clinical and patient decision making, and healthcare policy, to optimize the outcomes of stoma construction, and improve patients’ quality of life.
