Evidence map›Paper›PMID 41396324›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2025

Outcomes of surgical techniques for parastomal hernia repair: a bayesian network meta-analysis.

Jose Martín-Arévalo, Victoria Alejandra Lopez-Callejon, David Moro-Valdezate, Stephanie Anne Garcia-Botello, Leticia Perez-Santiago, Monica Millan, Fernando Lopez-Mozos, Guillermo Lillo-Albert, Julieta Puente-Monserrat, Vicente Pla-Marti

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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

3 citing papers in PubMed.

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

10 authors.

Jose Martín-ArévaloHospital Clinico Universitario Valencia, Valencia, Spain. martin_jose@gva.es.ORCID 0000-0001-5337-9577
Victoria Alejandra Lopez-CallejonHospital Clinico Universitario Valencia, Valencia, Spain.
David Moro-ValdezateHospital Clinico Universitario Valencia, Valencia, Spain.
Stephanie Anne Garcia-BotelloHospital Clinico Universitario Valencia, Valencia, Spain.
Leticia Perez-SantiagoHospital Clinico Universitario Valencia, Valencia, Spain.
Monica MillanHospital Clinico Universitario Valencia, Valencia, Spain.
Fernando Lopez-MozosHospital Clinico Universitario Valencia, Valencia, Spain.
Guillermo Lillo-AlbertHospital Clinico Universitario Valencia, Valencia, Spain.
Julieta Puente-MonserratHospital Clinico Universitario Valencia, Valencia, Spain.
Vicente Pla-MartiHospital Clinico Universitario Valencia, Valencia, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo determine the relative efficacy and safety of surgical techniques for parastomal hernia (PH) repair using a Bayesian network meta-analysis (NMA), integrating direct and indirect evidence to generate probabilistic rankings and guide clinical decision-making.

methodsWe conducted a systematic review and Bayesian NMA of 28 studies (1.983) patients) comparing seven PH repair techniques, following PRISMA-NMA guidelines. The primary outcome was parastomal hernia (PH) recurrence; the secondary outcome was cumulative postoperative complications. Random-effects models with a binomial likelihood and a logit link function were used. SUCRA probabilities ranked interventions; node-splitting assessed inconsistency; meta-regression evaluated covariates.

resultsFunnelMesh achieved the highest SUCRA score for recurrence reduction (91.55%), significantly outperforming Keyhole (OR 0.06, 95% CrI: 0.01-0.35) and Repair (OR 0.11, 95% CrI: 0.02-0.55). Sandwich ranked second (80%). For complications, Modified Keyhole (KeyholeM) ranked safest (SUCRA = 91%), with a significantly lower complication risk than Sugarbaker (OR = 0.23; 95% CrI: 0.05-0.94) and Keyhole (OR = 0.22; 95% CrI: 0.04-0.92). Node-splitting revealed inconsistencies in the FunnelMesh comparisons, warranting cautious interpretation. Meta-regression confirmed robustness across stoma type, approach, and follow-up duration.

conclusionsFunnelMesh and Sandwich offered superior recurrence prevention; KeyholeM provides the optimal balance of low recurrence and minimal complications. The traditional Keyhole technique remained associated with high failure rates, reinforcing current guideline recommendations against its use. These findings provide an evidence-based framework to individualize PH repair strategies based on efficacy and safety trade-offs. HIGHLIGHTS: Bayesian network meta-analysis comparing all major techniques for parastomal hernia repair. FunnelMesh, Sandwich, and modified Keyhole achieve the best balance of efficacy and safety. Provides an evidence-based framework to guide surgical selection and patient counseling.

Indexed as

Hernia, VentralHerniorrhaphyIncisional HerniaSurgical StomasBayes TheoremHumansPostoperative ComplicationsRecurrenceColostomyHerniorrhaphyIleostomyIncisional herniaPostoperatative complicationsSurgical meshUrinary diversion

Identifiers

PMID41396324

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.