Ultrasound-Guided Botulinum Toxin A as an Adjunct to Intraoperative Fascial Traction in Incisional Hernia Repair: Registry-Based Cohort Study.

Diagnostics (Basel, Switzerland) 2026 Vol.16(5)

Malaibari Z, Aldemyati R, Niebuhr H, Dag H, Köckerling F

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Abstract

: AchievTing primary fascial closure in complex incisional hernia repair can be challenging when abdominal wall compliance is reduced. Preoperative ultrasound-guided botulinum toxin A (BTA) is used as a chemical component relaxation adjunct, and intraoperative fascial traction (IFT) is a traction-based technique to facilitate medialization. This study assessed the association of adding BTA to a traction-treated cohort. : Retrospective observational analysis of prospectively collected Herniamed Registry data from the Hamburg Hernia Center (1 February 2022-13 October 2025) was conducted. Elective incisional hernia repairs with IFT were included and stratified into BTA + IFT versus IFT-only. The primary outcome was primary fascial closure as documented in the registry. Categorical variables were compared using Fisher's exact test. : A total of 81 patients were analyzed (BTA + IFT, = 64; IFT-only, = 17). Primary fascial closure was achieved in 51/64 (79.7%) in the BTA + IFT group and 8/17 (47.1%) in the IFT-only group (OR 4.3, 95% CI 1.22-15.84; = 0.013). Mean operative time was similar (193 vs. 195 min). Mean length of stay was longer in the BTA + IFT group (8 vs. 5 days). Perioperative complications were recorded 8/64 (12.5%) in the BTA + IFT group and 0/17 (0.0%) in the IFT-only group. : In traction-assisted incisional hernia repair, adjunctive preoperative ultrasound-guided BTA was associated with higher primary fascial closure rates compared with traction alone. Findings are hypothesis-generating due to non-randomized allocation and baseline differences between cohorts.

추출된 의학 개체 (NER)

유형영어 표현한국어 / 풀이UMLS CUI출처등장
시술 botulinum toxin 보툴리눔독소 주사 dict 2
해부 fascial scispacy 1
해부 BTA → botulinum toxin A scispacy 1
합병증 abdominal wall scispacy 1
합병증 incisional scispacy 1
약물 ultrasound-guided botulinum toxin A scispacy 1
약물 CI 1.22-15.84 scispacy 1
질환 Ultrasound-Guided Botulinum scispacy 1
질환 hernia C0019270
Hernia
scispacy 1
질환 BTA → botulinum toxin A scispacy 1
기타 Botulinum Toxin A scispacy 1
기타 Fascial scispacy 1
기타 IFT → intraoperative fascial traction scispacy 1
기타 BTA + IFT scispacy 1
기타 patients scispacy 1
기타 BTA + scispacy 1

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