Khirurgiia · 2026
[Botulinum toxin type A reducing extent of TAR procedure in patients with large postoperative hernias].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Chinikov M A, Othman H, Voynovskiy A E, Al-Ariki M K M, Kikhliarov P V, Elderkhanov M M
Аннотация
OBJECTIVE: To assess the feasibility of reducing the extent of TAR repair in patients with W3 postoperative ventral hernias through preliminary BTA injections into lateral abdominal muscles.
MATERIAL AND METHODS: The study included 47 patients with midline POVH classified as W3. Eleven patients (group 1) received injections of BTA 500 U four weeks prior to scheduled unilateral TAR procedure. Group 2 (n=36) underwent standard bilateral TAR without BTA injections. Group 1 was characterized by significantly higher ASA class (p=0.011), Tanaka index (0.23±0.01 vs. 0.19±0.02; p=0.001) and fascial defect width (16.8 cm vs. 15.3 cm; p=0.01) and length (18 cm vs. 14 cm; p=0.005). Both groups were comparable in other parameters.
RESULTS: After BTA administration, fascial defect width reduced from 16.8 to 12.96 cm (p<0.001) and Tanaka index reduced from 0.23 to 0.21 (p=0.002) in group 1. Unilateral TAR was successfully performed in 72.7% of patients. Group 1 demonstrated significantly shorter surgery time (158.1±11.0 vs. 287.8±87.0 min; p<0.001) and hospital-stay (4 vs. 8 days; p=0.02) with comparable rate of severe complications. No between-group differences in quality of life were observed after 6 months (p=0.596).
CONCLUSION: Preoperative BTA administration in patients with large midline POVH allows for less extent of TAR repair.
MATERIAL AND METHODS: The study included 47 patients with midline POVH classified as W3. Eleven patients (group 1) received injections of BTA 500 U four weeks prior to scheduled unilateral TAR procedure. Group 2 (n=36) underwent standard bilateral TAR without BTA injections. Group 1 was characterized by significantly higher ASA class (p=0.011), Tanaka index (0.23±0.01 vs. 0.19±0.02; p=0.001) and fascial defect width (16.8 cm vs. 15.3 cm; p=0.01) and length (18 cm vs. 14 cm; p=0.005). Both groups were comparable in other parameters.
RESULTS: After BTA administration, fascial defect width reduced from 16.8 to 12.96 cm (p<0.001) and Tanaka index reduced from 0.23 to 0.21 (p=0.002) in group 1. Unilateral TAR was successfully performed in 72.7% of patients. Group 1 demonstrated significantly shorter surgery time (158.1±11.0 vs. 287.8±87.0 min; p<0.001) and hospital-stay (4 vs. 8 days; p=0.02) with comparable rate of severe complications. No between-group differences in quality of life were observed after 6 months (p=0.596).
CONCLUSION: Preoperative BTA administration in patients with large midline POVH allows for less extent of TAR repair.