Evidence map›Paper›PMID 34184138›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2022

Seven years of preoperative BTA abdominal wall preparation and the Macquarie system for surgical management of complex ventral hernia.

A Jacombs, K Elstner, O Rodriguez-Acevedo, J W Read, K Ho-Shon, M Wehrhahn, K Salazar, N Ibrahim

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Article in Hernia : the journal of hernias and abdominal wall surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

A JacombsHernia Institute Australia, Edgecliff, Australia.ORCID http://orcid.org/0000-0002-5773-1993
K ElstnerHernia Institute Australia, Edgecliff, Australia.ORCID http://orcid.org/0000-0002-2224-7165
O Rodriguez-AcevedoHernia Institute Australia, Edgecliff, Australia.ORCID http://orcid.org/0000-0001-7234-2913
J W ReadMacquarie University Hospital, Macquarie University, Sydney, Australia.ORCID http://orcid.org/0000-0003-4969-865X
K Ho-ShonMacquarie University Hospital, Macquarie University, Sydney, Australia.ORCID http://orcid.org/0000-0003-2804-6281
M WehrhahnDouglass Hanly Moir Pathology, Macquarie Park, Australia.ORCID http://orcid.org/0000-0003-1325-669X
K SalazarFaculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
N IbrahimHernia Institute Australia, Edgecliff, Australia. docnibrahim@gmail.com.ORCID http://orcid.org/0000-0002-8113-2798

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess 7-year outcomes after complex ventral hernia (CVH) repair using pre-operative Botulinum toxin A (BTA) injection and the Macquarie System of management.

methodsClinical examination and functional non-contrast abdominal CT scans were used to assess complications and recurrences encountered in a prospective series of 88 consecutive CVH repairs using pre-operative BTA injection (200 or 300 units) between November 2012 and December 2019. Pre-operative progressive pneumoperitoneum (PPP) and/or component separation (CS) were also used in some cases.

resultsAll hernia defects (mean transverse width 12.9 ± 5.2 cm) were successfully closed using either laparoscopic or laparoscopic-assisted open techniques facilitated by pre-operative BTA injection. The mean pre-operative post-BTA lateral oblique length gain was 4.7 ± 2.2 cm/side (p < 0.001). In 43 patients with defects < 12 cm wide, closure was achieved using BTA-only in 33 (76.7%), BTA + PPP in 2 (4.7%), BTA + CS in 5 (11.6%) and BTA + PPP + CS in 3 (7.0%). In the remaining 45 patients with defects [Formula: see text] 12 cm wide, closure was achieved using BTA-only in 9 (20.0%), BTA + PPP in 11 (24.4%), BTA + CS in 5 (11.1%) and BTA + PPP + CS in 20 (44.4%). There was a significant correlation between increasing defect size and the need for 2 or more CVH closure procedures (χ

conclusionPre-operative BTA injection of the abdominal wall is a safe procedure that facilitates hernia defect closure and reduces the need for CS, especially when defect size is less than 12 cm. BTA may also decrease the rate of hernia recurrence.

Indexed as

Abdominal WallBotulinum Toxins, Type AHernia, VentralLaparoscopyPneumoperitoneumHerniorrhaphyHumansPreoperative CareProspective StudiesRecurrenceSurgical MeshBotulinum Toxins, Type AAbdominal wall reconstructionBotulinum toxin AComplex ventral herniaLaparoscopyPreoperative managementRecurrence

Identifiers

PMID34184138

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.