{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T10:33:58Z","timestamp":1793183638850,"version":"4.5.0"},"reference-count":85,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Diverting loop ileostomies (DLI) are commonly used to protect high-risk anastomoses. While a higher body mass index (BMI) is known to increase postoperative morbidity, its specific effect on DLI-related complications is less well understood.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This systematic review and meta-analysis followed PRISMA guidelines, and Cochrane Library, Embase, PubMed, and Google Scholar were searched for English publications without time restrictions. Statistical analysis was performed using Meta-Mar v3.5.1.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Out of 586 studies yielded and 6 manually retrieved, 26 were included, totaling 5,141 patients (53.5% male). The mean ages were 35.0\u201365.3\u00a0years, and the mean BMI was 19.8\u201327.1\u00a0kg\/m<jats:sup>2<\/jats:sup>. Higher BMI increased stoma-site incisional hernia in 100% (<jats:italic>n<\/jats:italic>\u2009=\u20097) with a standardized mean difference of 0.88 (95% CI, 0.34\u20131.42). Two studies (40%) reported increased peristomal skin complications. One study each (100%) found increased risk for delayed reversal, stoma outlet obstruction, stoma-specific morbidity score, and longer operative time. Elevated BMI increased anastomotic leakage in 2 studies (50%), surgical site infection in 1 (33%), permanent stoma in 1 (20%), and overall complications in 2 (67%). However, no significant BMI differences were seen for high-output ileostomies, stoma retraction, parastomal hernia, complications after reversal, length of hospital stay, or mortality. BMI\u2009&gt;\u200930 was associated with higher complication risks overall (OR [95% CI], 2.01 [1.11\u20133.64]), but BMI\u2009&gt;\u200925 showed no significant difference except for stoma-site incisional hernia (OR [95% CI], 4.66 [3.54\u20136.14]) and parastomal hernia (OR [95% CI], 2.41 [1.70\u20133.40]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Increased\u00a0BMI is a risk factor for certain DLI-related complications, particularly stoma-site incisional hernia. If feasible, mesh placement at the ileostomy site should be strongly considered for patients with a BMI\u2009&gt;\u200925 to reduce the risk of stoma-site incisional hernia. Weight loss prior to DLI and reversal should be encouraged.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00464-025-11887-y","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T12:35:45Z","timestamp":1750941345000},"page":"5198-5213","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Higher BMI increases risk of stoma-site incisional hernia and other complications following diverting loop ileostomy and reversal: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5050-6626","authenticated-orcid":false,"given":"Kaiser O\u2019Sahil","family":"Sadiq","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swetha","family":"Lakshminarayanan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Ruiz Cota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia","family":"Marquez Castillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"issue":"2","key":"11887_CR1","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s00423-015-1275-1","volume":"400","author":"MH Hanna","year":"2015","unstructured":"Hanna MH, Vinci A, Pigazzi A (2015) Diverting ileostomy in colorectal surgery: when is it necessary? 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