Evidence map›Paper›PMID 40163250›Full record

SynthesisUpdates in surgery2026

Parastomal Hernia: direct repair versus relocation: is stoma relocation worth the risk? A comparative meta-analysis and systematic review.

Ahmed Abdelsamad, Mohammed Khaled Mohammed, Mohamed Badr Almoshantaf, Aya Alrawi, Ziad A Fadl, Ziad Tarek, Nada Osama Aboelmajd, Torsten Herzog, Florian Gebauer, Nada K Abdelsattar and 1 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 3 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

4 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Endoscopic totally extraperitoneal repair for parastomal hernia using the ePauli technique.Hernia : the journal of hernias and abdominal wall surgery · 2026
    Article
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

11 authors.

Ahmed AbdelsamadDepartment of Surgery II, University of Witten-Herdecke, 58455, Witten, Germany. ahmed6361410@gmail.com.ORCID http://orcid.org/0000-0002-5451-4504
Mohammed Khaled MohammedFaculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed Badr AlmoshantafDepartment of General Surgery, Ealing Hospital, LNWH Trust, London, UK.
Aya AlrawiFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Ziad A FadlFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Ziad TarekFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Nada Osama AboelmajdFaculty of Medicine, South Valley University, Qena, Egypt.
Torsten HerzogDepartment of Surgery II, University of Witten-Herdecke, 58455, Witten, Germany.
Florian GebauerOncological Surgery Department, Section Head of Robotic Surgery, Knappschaft Vest Hospital, 45657, Recklinghausen, Germany.
Nada K Abdelsattar *Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Taha Abd-ElSalam Ashraf Taha *Faculty of Medicine, Fayoum University, Fayoum, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Parastomal hernia is a prevalent and challenging complication in patients with stomas, frequently necessitating surgical intervention. The two primary approaches to parastomal hernia repair- direct repair without relocation and stoma relocation- offer distinct benefits and drawbacks. This systematic review and meta-analysis aimed to compare the efficacy and safety of stoma relocation versus direct repair in managing parastomal hernia. Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies involving adult patients (≥ 18 years) with parastomal hernia who underwent either stoma relocation or direct repair, with a focus on clinically relevant outcomes. A comprehensive search of Web of Science, PubMed, Scopus, and Cochrane Library databases was conducted up to September 2024. Key short-term outcomes (operative time, surgical site infection, urinary tract infection, bowel obstruction, length of hospital stay, and overall complications) and long-term outcomes (re-admission, recurrence, re-operation, and mortality) were extracted. Statistical analysis included risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes. Six studies were included, encompassing both laparoscopic and open-surgical techniques. Direct repair was associated with a significantly shorter operative time (MD: 115 min, 95% CI: 95.71 to 134, P < 0.00001) and a reduced length of hospital stay (MD: 2 days, 95% CI: 0.40 to 3.9, P = 0.02). While reoperation rates were significantly lower in the relocation group (RR: 0.15, 95% CI: 0.03 to 0.62, P = 0.009), other outcomes-including recurrence, re-admission, and overall complication rates-showed comparable results between the two approaches. Notably, there were no significant differences in surgical site infection, urinary tract infection, bowel obstruction, or mortality rates. Direct repair may be advantageous for reducing operative time and hospital stay, whereas stoma relocation appears beneficial in reducing reoperation rates. Future research should focus on developing standardized techniques and incorporating patient-specific factors to inform optimal surgical decision-making in parastomal hernia repair.

Indexed as

Hernia, VentralHerniorrhaphyIncisional HerniaSurgical StomasHumansLaparoscopyLength of StayOperative TimePostoperative ComplicationsReoperationTreatment OutcomeDirect repairDisplacementMeta-analysisOutcomesParastomal herniaStoma relocation

Identifiers

PMID40163250
PMCPMC12909359

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.