Preoperative Botulinum Toxin and Progressive Pneumoperitoneum in Loss of Domain Hernias—Our First 100 Cases
Objectives: Preoperative botulinum toxin type A (BT) and progressive pneumoperitoneum (PPP) are useful tools in the preparation of patients with loss of domain hernias (LODH). The purpose of our retrospective study is to report our experience in the treatment of 100 consecutive patients with LODH, w...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-02-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fsurg.2020.00003/full |
| _version_ | 1830359146656956416 |
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| author | José Bueno-Lledó Omar Carreño-Saenz Antonio Torregrosa-Gallud Salvador Pous-Serrano |
| author_facet | José Bueno-Lledó Omar Carreño-Saenz Antonio Torregrosa-Gallud Salvador Pous-Serrano |
| author_sort | José Bueno-Lledó |
| collection | DOAJ |
| description | Objectives: Preoperative botulinum toxin type A (BT) and progressive pneumoperitoneum (PPP) are useful tools in the preparation of patients with loss of domain hernias (LODH). The purpose of our retrospective study is to report our experience in the treatment of 100 consecutive patients with LODH, with the combined use of these techniques.Methods: Of the 753 patients operated on for ventral incisional hernia between June 2010 and December 2018 in our hospital, 100 patients with LODH were analyzed retrospectively. Diameters of abdominal cavity and hernia sac, and volumes of incisional hernia (VIH) and abdominal cavity (VAC) were calculated from CT scan, based on the index of Tanaka.Results: The median insufflated volume of air for PPP was 8,600 ± 4,200 cc (4,500–15,250). BT administration time was 38.2 days (33–48). A significant average reduction of 15% of the VIH/VAC ratio was observed on CT scan after the combination of PPP and BT (p = 0.001). Anterior component separation (CST) and transversus abdominis release (TAR) were the most frequent repair techniques. Complete fascial closure was possible in 97%, and mesh bridging was needed in three cases. In postoperative follow-up of 34.5 months (11–62), we reported eight cases of hernia recurrence (8%).Conclusion: PPP and BT are useful tools in the treatment of LODH. These techniques significantly reduce the VIH/VAC ratio, allowing the reduction of the hernia content into the abdominal cavity, which represents a key factor in the management of these hernias. |
| first_indexed | 2024-12-20T02:54:21Z |
| format | Article |
| id | doaj.art-dfd36e6b352f449692f75944606f570f |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-20T02:54:21Z |
| publishDate | 2020-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-dfd36e6b352f449692f75944606f570f2022-12-21T19:55:58ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2020-02-01710.3389/fsurg.2020.00003511271Preoperative Botulinum Toxin and Progressive Pneumoperitoneum in Loss of Domain Hernias—Our First 100 CasesJosé Bueno-LledóOmar Carreño-SaenzAntonio Torregrosa-GalludSalvador Pous-SerranoObjectives: Preoperative botulinum toxin type A (BT) and progressive pneumoperitoneum (PPP) are useful tools in the preparation of patients with loss of domain hernias (LODH). The purpose of our retrospective study is to report our experience in the treatment of 100 consecutive patients with LODH, with the combined use of these techniques.Methods: Of the 753 patients operated on for ventral incisional hernia between June 2010 and December 2018 in our hospital, 100 patients with LODH were analyzed retrospectively. Diameters of abdominal cavity and hernia sac, and volumes of incisional hernia (VIH) and abdominal cavity (VAC) were calculated from CT scan, based on the index of Tanaka.Results: The median insufflated volume of air for PPP was 8,600 ± 4,200 cc (4,500–15,250). BT administration time was 38.2 days (33–48). A significant average reduction of 15% of the VIH/VAC ratio was observed on CT scan after the combination of PPP and BT (p = 0.001). Anterior component separation (CST) and transversus abdominis release (TAR) were the most frequent repair techniques. Complete fascial closure was possible in 97%, and mesh bridging was needed in three cases. In postoperative follow-up of 34.5 months (11–62), we reported eight cases of hernia recurrence (8%).Conclusion: PPP and BT are useful tools in the treatment of LODH. These techniques significantly reduce the VIH/VAC ratio, allowing the reduction of the hernia content into the abdominal cavity, which represents a key factor in the management of these hernias.https://www.frontiersin.org/article/10.3389/fsurg.2020.00003/fullincisional herniaventral hernialarge incisional herniapreoperative progressive pneumoperitoneumbotulinum toxin |
| spellingShingle | José Bueno-Lledó Omar Carreño-Saenz Antonio Torregrosa-Gallud Salvador Pous-Serrano Preoperative Botulinum Toxin and Progressive Pneumoperitoneum in Loss of Domain Hernias—Our First 100 Cases Frontiers in Surgery incisional hernia ventral hernia large incisional hernia preoperative progressive pneumoperitoneum botulinum toxin |
| title | Preoperative Botulinum Toxin and Progressive Pneumoperitoneum in Loss of Domain Hernias—Our First 100 Cases |
| title_full | Preoperative Botulinum Toxin and Progressive Pneumoperitoneum in Loss of Domain Hernias—Our First 100 Cases |
| title_fullStr | Preoperative Botulinum Toxin and Progressive Pneumoperitoneum in Loss of Domain Hernias—Our First 100 Cases |
| title_full_unstemmed | Preoperative Botulinum Toxin and Progressive Pneumoperitoneum in Loss of Domain Hernias—Our First 100 Cases |
| title_short | Preoperative Botulinum Toxin and Progressive Pneumoperitoneum in Loss of Domain Hernias—Our First 100 Cases |
| title_sort | preoperative botulinum toxin and progressive pneumoperitoneum in loss of domain hernias our first 100 cases |
| topic | incisional hernia ventral hernia large incisional hernia preoperative progressive pneumoperitoneum botulinum toxin |
| url | https://www.frontiersin.org/article/10.3389/fsurg.2020.00003/full |
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