Using synthetic mesh for parastomal hernia repair reduces long-term recurrence risk compared to biologic mesh, which is crucial for surgical decision-making.

• Parastomal hernia recurrence rate at 5 years was 33.6% overall (37.5% for biologic vs. 29.4% for synthetic).
• Synthetic mesh showed a 45% reduction in recurrence risk (HR=0.65, p=0.028).

Consider using synthetic mesh for better long-term outcomes without increased mesh-related complications.

• 14% of patients required reoperation, with slightly more in the biologic group (9 vs. 6).