WTP4.1 Can Deep Stomal Fixation and Extraperitoneal Stoma Creation Improve Stoma Morbidity? Systematic Review and Meta-Analysis

Abstract Aim This systematic review evaluates the efficacy and safety of two operative techniques: deep stomal fixation (fixation stoma to sheath abdominal wall muscles and/or peritoneum) extraperitoneal approach creation. Method PubMed, Medline, Cochrane, Google Scholar were searched for studies comparing peritoneum conventional skin-only transperitoneal approaches formation. Clinical endpoints included parastomal hernia (PSH), prolapse, retraction associated adverse effects. Results 2 randomised retrospective investigated fixation. There was no statistically significant benefit this technique in terms PSH (OR 1.19, P=0.82), prolapse 0.62, P=0.53) or 1.16, P=0.80). Some technical difficulties on reversal reported one studies. As creation, 8 compared it approach. A notable reduction identified stomas 0.29, P=0.004). showed insignificant 0.74, 0.48, P=0.36). difference time (MD 3.45, P=0.71) risk small bowel obstruction 0.68, P=0.57). Conclusion Stoma muscle does not lower complications, conversely may make technically challenging. Extraperitoneal minimises occurrence with remarkable effects; yet more trials are required further evaluation.