Prevalence and risk factors of incisional hernia after ileostomy reversal: meta-analysis with meta-regression.

IF 2.4 2区医学 Q1 SURGERY

Hernia Pub Date : 2025-06-16 DOI:10.1007/s10029-025-03367-y

Salsabil Nasri, Neyrouz Kammoun, Mohamed Mehdi Trabelsi, Amine Ben Safta, Imen Samaali, Chadli Dziri, Ramzi Nouira

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引用次数: 0

Abstract

Background: The rate of incisional hernia (IH) at stoma site after ileostomy closure is controversial in the literature. We aimed to estimate the prevalence of IH at stoma site after ileostomy reversal and to determine its risk factors.

Material and methods: We performed a systematic review according to PRISMA standards to identify studies reporting prevalence of IH after ileostomy closure. Meta-analysis was performed to estimate its rate. Heterogeneity was explained by meta-regression and subgroup analysis.

Results: Twenty studies were included with 2629 patients. The pooled estimated rate was 13,7% with a 95% confidence interval (11-17%). The 95% prediction interval varied between 5,3% and 31,1%, which showed substantial heterogeneity. Meta-regression showed that ASA score III and IV increases IH rate (p = 0,02). Obese and elderly patients have a tendency for developing IH with substantial heterogeneity. Subgroup analysis for COPD, diabetes mellitus, smoking, laparotomy approach for the initial surgery, did not show statistically significant differences.

Conclusion: Prevalence of IH is higher than previously estimated in the literature. ASA score III and IV increases its rate. Prospective randomized studies focusing on the impact of prophylactic mesh implementation are necessary.

查看原文本刊更多论文

回肠造口术逆转后切口疝的患病率和危险因素：荟萃分析与荟萃回归。

背景：关于回肠造口术后造口部位切口疝（IH）的发生率在文献中存在争议。我们的目的是估计回肠造口术后造口部位IH的患病率，并确定其危险因素。材料和方法：我们根据PRISMA标准进行了系统回顾，以确定报告回肠造口闭合后IH患病率的研究。采用meta分析估计其发生率。异质性通过meta回归和亚组分析解释。结果：纳入20项研究，2629例患者。合并估计率为13.7%，95%置信区间（11-17%）。95%预测区间在5.3% ~ 31.1%之间，存在较大的异质性。meta回归显示，ASA评分III和IV会增加IH率（p = 0.02）。肥胖和老年患者有发生IH的倾向，但存在很大的异质性。亚组分析以COPD、糖尿病、吸烟、开腹入路为首发手术，差异无统计学意义。结论：IH患病率高于先前文献估计。ASA评分为III和IV会增加其发生率。前瞻性随机研究关注预防性补片实施的影响是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.