Evidence map›Paper›PMID 37353652›Full record

ArticleSurgical endoscopy2023

Single-staged retromuscular abdominal wall reconstruction with mesh at the time of ostomy reversal: are we crossing the line? An ACHQC Analysis.

Megan Melland-Smith, Benjamin Miller, Clayton Petro, Lucas Beffa, Ajita Prabhu, David Krpata, Molly LaBelle, Robert Tamer, Michael Rosen

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Megan Melland-SmithCenter for Abdominal Core Health, Department of General Surgery, Cleveland Clinic Foundation, Digestive Disease and Surgery Institute, 9500 Euclid Ave, Crile Building, 10th Floor, Cleveland, OH, USA. Mmellandsmith88@gmail.com.
Benjamin MillerCenter for Abdominal Core Health, Department of General Surgery, Cleveland Clinic Foundation, Digestive Disease and Surgery Institute, 9500 Euclid Ave, Crile Building, 10th Floor, Cleveland, OH, USA.
Clayton PetroCenter for Abdominal Core Health, Department of General Surgery, Cleveland Clinic Foundation, Digestive Disease and Surgery Institute, 9500 Euclid Ave, Crile Building, 10th Floor, Cleveland, OH, USA.
Lucas BeffaCenter for Abdominal Core Health, Department of General Surgery, Cleveland Clinic Foundation, Digestive Disease and Surgery Institute, 9500 Euclid Ave, Crile Building, 10th Floor, Cleveland, OH, USA.
Ajita PrabhuCenter for Abdominal Core Health, Department of General Surgery, Cleveland Clinic Foundation, Digestive Disease and Surgery Institute, 9500 Euclid Ave, Crile Building, 10th Floor, Cleveland, OH, USA.
David KrpataCenter for Abdominal Core Health, Department of General Surgery, Cleveland Clinic Foundation, Digestive Disease and Surgery Institute, 9500 Euclid Ave, Crile Building, 10th Floor, Cleveland, OH, USA.
Molly LaBelleCornell University, Ithaca, NY, USA.
Robert TamerThe Ohio State University, Columbus, OH, USA.
Michael RosenCenter for Abdominal Core Health, Department of General Surgery, Cleveland Clinic Foundation, Digestive Disease and Surgery Institute, 9500 Euclid Ave, Crile Building, 10th Floor, Cleveland, OH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe most appropriate method of reconstructing the abdominal wall at the site of a simultaneous stoma takedown is controversial. The contaminated field, concomitant GI procedure being performed and presence of a hernia all complicate decision-making. We sought to describe the surgical approaches, mesh type and outcomes of concomitant abdominal wall reconstruction during stoma takedown in a large hernia registry. METHODS AND PROCEDURES: All patients who underwent stoma takedown with simultaneous hernia repair with retromuscular mesh placement from January 2014 to May 2022 were identified within the Abdominal Core Health Quality Collaborative (ACHQC). Patients were stratified by mesh type including permanent synthetic (PS), resorbable synthetic (RS) and biologic mesh. Association of mesh type with 30-day wound events and other complications and 1-year outcomes were evaluated.

resultsThere were 368 patients who met inclusion criteria. Eighty-nine patients had ileostomies, 276 colostomies and 3 had both. Two hundred and seventy-nine (75.8%) patients received PS mesh, 46 (12.5%) biologic, and 43 (11.7%) RS. Seventy percent (259/368) had a parastomal hernia, 75% (285/368) had a midline incisional hernia, and 48% (178/368) had both. All groups had similar preoperative comorbidities and the majority had a transversus abdominus release. All mesh groups had similar thirty-day SSI (13.2-14.3%), SSO (10.5-17.8%) and SSOPI (7.9-14.1%), p = 0.6. Three patients with PS mesh developed infected synthetic mesh and one PS mesh required excision. Four patients with PS developed an enterocutaneous fistula. Of these, only one patient was recorded as having both an enterocutaneous fistula and mesh infection. Thirty-day reoperation and readmission were similar across all mesh groups. Recurrence at 1-year was similar between mesh groups. Quality of life measured using HerQLes scores were higher at one year compared to baseline in all groups indicating improvement in hernia-specific quality of life.

conclusionEarly complication rates associated with simultaneous stoma takedown and abdominal wall reconstruction are significant, regardless of mesh type utilized. Concomitant surgery should be weighed heavily and tailored to individual patients.

Indexed as

Abdominal WallBiological ProductsHernia, VentralIncisional HerniaIntestinal FistulaOstomyHerniorrhaphyHumansQuality of LifeRetrospective StudiesSurgical MeshTreatment OutcomeBiological ProductsConcomitantHerniaMeshReconstructionReversalStoma

Identifiers

PMID37353652

What OpenQuestion holds

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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.