{
  "abstract": "Background\n\nParastomal hernia (PSH) is one of the most common long-term complications after enterostomy. Prophylactic mesh can reduce PSH risk but is limited by mesh-related adverse events and high costs. This study aimed to evaluate the efficacy and safety of prophylactic full-thickness rectus abdominis suturing for PSH prevention without implant materials.Methods\n\nThis single-center retrospective cohort study enrolled 244 patients undergoing enterostomy from January 2020 to December 2024. Patients were allocated alternately by calendar-month: 94 patients received full-thickness rectus-suture reinforcement (reinforcement group), and 150 underwent conventional stoma creation (conventional group). The primary endpoint was CT-confirmed PSH incidence within 2-year follow-up. Secondary endpoints included hernia-sac diameter, time-to-PSH-onset and stoma-related complications. Univariable and multivariable logistic regression, Firth penalized regression, 1:1 propensity-score-matching (PSM), Kaplan-Meier survival analysis and interrupted time-series (ITS) segmented regression were performed.Results\n\nThe reinforcement group showed significantly lower 2-year PSH incidence (9.6% vs. 27.3%, P < 0.001). Suture reinforcement was an independent protective factor against PSH (adjusted OR = 0.29, 95% CI: 0.13-0.65, P = 0.002), and Firth-penalized logistic regression confirmed the stability of this finding (OR = 0.31, 95% CI: 0.14-0.68, P = 0.003). After PSM, the inter-group difference remained significant (14.9% vs. 31.9%, P = 0.006), and multivariable regression in the matched cohort still identified suture reinforcement as an independent protective factor (adjusted OR = 0.35, 95% CI: 0.17-0.72, P = 0.004). Patients in the reinforcement group had smaller hernia-sac diameter (2.9 cm vs. 7.3 cm, P < 0.001) and delayed PSH onset (12.2 months vs. 6.7 months, P = 0.001). ITS analysis supported the robustness of observational findings. Early postoperative complication rates were comparable between groups.Conclusions\n\nProphylactic full-thickness rectus-abdominis suturing is associated with reduced PSH incidence, delayed hernia onset and milder hernia severity. This implant-free, low-cost technique is safe and simple. Prospective randomized trials are needed to further validate its clinical value.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Colorectal and Anal Surgery, Shengzhou People's Hospital (Shengzhou Branch of the First Affiliated Hospital of Zhejiang University School of Medicine, Shengzhou Hospital of Shaoxing University), Shaoxing, China.",
    "Ningbo University, Ningbo, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Guoqiang Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Bowen Zheng"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3eczkvcdavhyr.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1978158",
  "fulltext_url": "https://europepmc.org/articles/PMC13683082",
  "id": "3eczkvcdavhyr",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42908567",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Stoma care and complications"
    ]
  ],
  "openalex": "W7220832045",
  "pdf_url": "https://europepmc.org/articles/PMC13683082?pdf=render",
  "pmcid": "PMC13683082",
  "pmid": "42908567",
  "published": "2026-10-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3eczkvcdavhyr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:53Z",
      "native_id": "MED:42908567",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42908567"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Stoma care and complications",
      "subfield": "surgery"
    }
  ],
  "title": "Prophylactic full-thickness suturing of the rectus abdominis muscle reduces parastomal hernia after enterostomy: a 5-year retrospective cohort study.",
  "title_text": "Prophylactic full-thickness suturing of the rectus abdominis muscle reduces parastomal hernia after enterostomy: a 5-year retrospective cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:53Z",
  "url": "https://research.draconitic.com/paper/3eczkvcdavhyr",
  "venue": "Frontiers in medicine",
  "versions": []
}