Discussion
RECRUITMENT
Given the high rate of IH after loop ileostomy closure with its associated morbidity, loss of health-related quality of life and costs, prophylactic measures after ostomy closure are urgently needed. Prophylactic mesh implantation at the time of surgical stoma reversal has shown to be a promising and safe method to prevent IH formation. However, the efficacy of this method has not yet been investigated in a large multicentre RCT with adequate external validity. P.E.L.I.O.N will fill this evidence gap. The aim of the PELION trial is to evaluate the efficacy of prophylactic mesh reinforcement after loop ileostomy closure in decreasing the rate of IH versus standard closure alone. Recruitment of patients has started in October 2022 and is going as projected.Besides P.E.L.I.O.N, four planned randomised controlled trials are registered in available international registries, all with relevant weaknesses in the trial design, making interpretation and generalisation of the results doubtful (see Table Planned studies currently registered