Evidence map›Paper›PMID 32800407›Full record

Trial reportEuropean urology2020

Preventing Parastomal Hernia After Ileal Conduit by the Use of a Prophylactic Mesh: A Randomised Study.

Fredrik Liedberg, Petter Kollberg, Marie Allerbo, Gediminas Baseckas, Johan Brändstedt, Sigurdur Gudjonsson, Oskar Hagberg, Ulf Håkansson, Tomas Jerlström, Annica Löfgren and 3 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European urology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 5 pooled it
6.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 5 syntheses or guidelines pooled it, 54 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Review
  8. Review
  9. Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Prophylactic Mesh in Parastomal Hernia Prevention: Current Evidence.Journal of abdominal wall surgery : JAWS · 2025
    Review
  18. Article
  19. Development and preliminary evaluation of a novel procedure for creation of an ileal conduit stoma aimed at preventing parastomal hernia.International journal of urology : official journal of the Japanese Urological Association · 2024
    Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 2 countries.

Fredrik LiedbergInstitution of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden. Electronic address: fredrik.liedberg@med.lu.se.
Petter KollbergInstitution of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden; Department of Urology, Helsingborg County Hospital, Helsingborg, Sweden.
Marie AllerboDepartment of Urology, Helsingborg County Hospital, Helsingborg, Sweden.
Gediminas BaseckasInstitution of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden.
Johan BrändstedtInstitution of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden.
Sigurdur GudjonssonDepartment of Urology, Landspitali University Hospital, Reykjavik, Iceland.
Oskar HagbergInstitution of Translational Medicine, Lund University, Malmö, Sweden; Regional Cancer Centre South, Region Skåne, Lund, Sweden.
Ulf HåkanssonDepartment of Urology, Skåne University Hospital, Malmö, Sweden.
Tomas JerlströmDepartment of Urology, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
Annica LöfgrenInstitution of Translational Medicine, Lund University, Malmö, Sweden.
Oliver PatschanInstitution of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden.
Anne SörenbyInstitution of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden.
Mats BläckbergDepartment of Urology, Helsingborg County Hospital, Helsingborg, Sweden.
Lund University · SEHelsingborgs lasarett · SEÖrebro University · SEReykjavík University · ISSkåne University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundParastomal hernia (PSH) after urinary diversion with ileal conduit is frequently a clinical problem.

objectiveTo investigate whether a prophylactic lightweight mesh in the sublay position can reduce the cumulative incidence of PSH after open cystectomy with ileal conduit. DESIGN, SETTING, AND

participantsFrom 2012 to 2017, we randomised 242 patients 1:1 to conventional stoma construction (n = 124) or prophylactic mesh (n = 118) at three Swedish hospitals (ISRCTN 95093825). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoint was clinical PSH, and secondary endpoints were radiological PSH assessed in prone position with the stoma in the centre of a ring, parastomal bulging, and complications from the mesh. RESULTS AND LIMITATIONS: Within 24 mo, 20/89 (23%) patients in the control arm and 10/92 (11%) in the intervention arm had developed a clinical PSH (p = 0.06) after a median follow-up of 3 yr, corresponding to a hazard ratio of 0.45 (confidence interval 0.24-0.86, p = 0.02) in the intervention arm. The proportions of radiological PSHs within 24 mo were 22/89 (25%) and 17/92 (19%) in the two study arms. During follow-up, five patients in the control arm and two in the intervention arm were operated for PSH. The median operating time was 50 min longer in patients receiving a mesh. No differences were noted in proportions of Clavien-Dindo complications at 90 d postoperatively or in complications related to the mesh during follow-up.

conclusionsProphylactic implantation of a lightweight mesh in the sublay position decreases the risk of PSH when constructing an ileal conduit without increasing the risk of complications related to the mesh. The median surgical time is prolonged by mesh implantation. PATIENT SUMMARY: In this randomised report, we looked at the risk of parastomal hernia after cystectomy and urinary diversion with ileal conduit with or without the use of a prophylactic mesh. We conclude that such a prophylactic measure decreased the occurrence of parastomal hernias, with only a slight increase in operating time and no added risk of complications related to the mesh.

Indexed as

CystectomySurgical MeshSurgical StomasUrinary DiversionAgedFemaleHumansIncisional HerniaMaleProspective StudiesUrinary Bladder NeoplasmsBladder cancerCystectomyIleal conduitParastomal herniaProphylactic mesh

Identifiers

PMID32800407
OpenAlexW3048822051

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.