SynthesisUpdates in surgery2026
Supporting or complicating? The role of rods and bridges in loop stomas: a comprehensive systematic review and meta-analysis with GRADE evaluation and trial sequential analysis.
Synthesis in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This systematic review and meta-analysis investigated the efficacy and safety of support rods and bridges in loop stoma formation, a practice frequently employed in colorectal surgery despite the associated complications and controversial efficacy. The aim of this study is to provide evidence-based guidance on their routine use. Adhering to the Cochrane Collaboration's recommendations, we conducted this systematic review and meta-analysis systematically searching PubMed, Scopus and Web of Science for randomized controlled trials (RCTs) evaluating the efficacy of rods/ bridges in loop ileostomies. Key outcomes assessed included stoma retraction, stoma/skin necrosis, peristomal dermatitis, infection, and mucocutaneous separation. This review included six studies encompassing 1,239 patients (195 ileostomy, 1,044 colostomy). Analysis revealed no statistically significant difference in stoma retraction (RR = 0.70, 95% CI [0.37 to 1.33], P = 0.28). Conversely, for stoma/skin necrosis, four studies were analyzed and showed a statistically significant difference favoring the non-rod/bridge group (RR = 5.04, 95% CI [1.72 to 14.73], P = 0.003). For peristomal dermatitis, three studies revealed a statistically significant difference favoring the non-rod/bridge group (RR = 2.01, 95% CI [1.55 to 2.60], P < 0.00001), with ostomy rod use identified as a significant risk factor (OR 3.42, p < 0.01). Outcomes for infection and mucocutaneous separation showed no significant difference. Based on the our results, routine rod/bridge use does not appear to reduce stoma retraction and may be associated with an increased risk of necrosis and dermatitis. That is why the routine use of rod/bridge does not appear to be justified, but the small number of the included studies limit the generalizability of these results. Trial sequential analysis indicated that future high-quality RCTs with diverse and larger populations and are recommended to obtain more rigorous evidence.
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