Ultrasound-Guided Botulinum Toxin A as an Adjunct to Intraoperative Fascial Traction in Incisional Hernia Repair: Registry-Based Cohort Study.
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)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 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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