Parastomal Hernias: Prevention, Repair Techniques, and Standardizing Guideline-Based Decision-Making

Parastomal hernias are among the most frequent long-term complications of stoma formation and can cause pain, impaired function, appliance difficulties, bowel obstruction, incarceration, and reduced quality of life. Despite advances in abdominal wall reconstruction, substantial variation remains in the use of prophylactic mesh, choice of mesh position and configuration, indications for elective repair, operative technique, and postoperative follow-up. Current evidence suggests that patient-related factors, stoma characteristics, surgical approach, and the quality of fascial and abdominal wall reconstruction all influence hernia development and recurrence. However, uncertainty persists regarding the comparative effectiveness of prophylactic strategies, the optimal management of asymptomatic or minimally symptomatic hernias, and the role of open, laparoscopic, and robotic approaches. Emerging studies are addressing these questions through prospective cohorts, randomized trials, registry analyses, and consensus-based guidelines, but differences in outcome definitions, follow-up duration, and reporting standards limit comparison between studies. Further investigation is needed to integrate prevention, individualized risk assessment, repair selection, and long-term outcomes into consistent, evidence-informed clinical pathways.This Research Topic aims to advance understanding of the prevention and treatment of parastomal hernias and to support standardized, guideline-based decision-making across the continuum of care. It will examine how patient, disease, stoma, and procedural factors can inform risk stratification and treatment selection; evaluate the effectiveness and safety of prophylactic and therapeutic mesh strategies; and assess outcomes associated with contemporary reconstructive techniques. Contributions may also help clarify indications for conservative management, elective repair, and urgent intervention, while identifying priorities for future clinical trials, registries, and consensus recommendations.To gather further insights into prevention, risk assessment, surgical repair, and long-term management of parastomal hernias, we welcome articles addressing, but not limited to, the following themes:• Risk factors, prediction models, and individualized risk stratification;• Prophylactic mesh placement at the time of stoma creation;• Mesh materials, positioning, fixation, and configuration;• Open, laparoscopic, robotic, and hybrid repair techniques;• Component separation and abdominal wall reconstruction;• Keyhole, Sugarbaker, sandwich, and other repair approaches;• Management of asymptomatic, symptomatic, recurrent, incarcerated, or strangulated hernias;• Stoma relocation, reversal, and strategies for preserving stoma function;• Perioperative optimization and enhanced recovery pathways;• Complications, recurrence, quality of life, and patient-reported outcomes;• Comparative effectiveness, cost-effectiveness, and health services research;• Standardized definitions, outcome measures, registries, and guideline implementation;• Consensus statements, decision algorithms, and evidence gaps guiding future research.Accepted article types include, but are not limited to, Original Research, Brief Research Report, Systematic Review, Review, Meta-Analysis, Clinical Trial, Study Protocol, Methods, Data Report, Perspective, Opinion, and General Commentary. Topic editors: Eugenio Licardie, Boris Eugeniev Sakakushev, Salvador Morales-Conde Source: https://www.frontiersin.org/research-topics/84958/parastomal-hernias-prevention-repair-techniques-and-standardizing-guideline-based-decision-making