Evidence map›Paper›PMID 37329437›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2023

Systematic review and meta-analysis of the pre-operative application of botulinum toxin for ventral hernia repair.

E R M Dias, G Z Rondini, P H F Amaral, J Z Macret, J P V Carvalho, L G A Pivetta, C A Malheiros, S Roll

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
8.6field-weighted citation impact, top 2% of its field
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

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Basal Tone, Muscle Memory and Denervation: Pathophysiological Foundations of Abdominal Wall Hernia Development and Recovery.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026
    Review
  3. Review
  4. Article
  5. Article
  6. Article
  7. Observational
  8. Article
  9. Article
  10. Article
  11. Follow-up of complex hernia repair with intraoperative fascial traction.Hernia : the journal of hernias and abdominal wall surgery · 2025
    Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Intra-abdominal hypertension and compartment syndrome after complex hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2024
    Review
  20. Article
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 at 2 institutions in 1 country.

E R M DiasFaculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil. ermdias.cirurgia@gmail.com.ORCID 0000-0001-9679-1887
G Z RondiniFaculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil.ORCID 0000-0002-8473-2713
P H F AmaralFaculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil.ORCID 0000-0003-3999-210X
J Z MacretFaculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil.ORCID 0000-0003-2764-4597
J P V CarvalhoFaculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil.ORCID 0000-0001-6716-3793
L G A PivettaFaculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil.ORCID 0000-0001-7895-4048
C A MalheirosFaculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil.ORCID 0000-0002-5730-7973
S RollFaculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil.ORCID 0000-0002-4381-5969
Hospital Alemão Oswaldo Cruz · BRFaculdade de Ciências Médicas da Santa Casa de São Paulo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical repair of large hernia defects requires detailed pre-operative planning, particularly in cases with loss of domain. This situation often hampers mid-line reconstruction, even after component separation, when the size of the hernia is disproportional to the volume of the abdominal area. In this case, other strategies may be needed to place the viscera back into the abdominal cavity after reducing the hernia sac. The administration of botulinum toxin prior to the surgical procedure has been indicated as an adjunct for more complex cases. This results in stretching of the lateral musculature of the abdomen, allowing midline approximation. In addition, the application of botulinum toxin alone has been investigated as a means of downstaging in the management of ventral hernias, thereby precluding component separation and enabling primary closure of the midline by placement of mesh within the retromuscular space using the Rives Stoppa technique.

methodsSystematic review of the literature for observational studies involving patients undergoing pre-operative application of botulinum toxin for ventral hernia repair was conducted according to the PRISMA guidelines.

resultsAdvance of the lateral musculature of the abdomen by an average of 4.11 cm with low heterogeneity, as well as low rates of surgical site infection (SSI), surgical site occurrences (SSO) and recurrence, was shown.

conclusionPre-operative application of botulinum toxin for ventral hernia repair promoted an increase in the length of the lateral musculature of the abdomen which can help improve the outcomes of morbidity and recurrence.

Indexed as

Abdominal WallBotulinum Toxins, Type AHernia, VentralHerniorrhaphyHumansRecurrenceSurgical MeshBotulinum Toxins, Type AAbdominal wallBotulinum toxinIncisional herniaVentral hernia

Identifiers

PMID37329437
OpenAlexW4381053164

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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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.