SynthesisHernia : the journal of hernias and abdominal wall surgery2025
Effect of preoperative botulinum toxin injection in the treatment of giant incisional hernias: a systematic review and meta-analysis.
Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
The trial behind it
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Who cites it
3 citing papers in PubMed.
- 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 · 2026Review
- Preoperative Botulinum Toxin Type A Use in Giant Inguinal Hernia Repair: A Scoping Review.Medical sciences (Basel, Switzerland) · 2026Article
- French nationwide monthly online consultation meeting on complex abdominal wall repairs: 4-year assessment of an innovative collaborative decision-making tool.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionGiant incisional hernias pose a significant surgical challenge due to their high morbidity, risk of postoperative complications, and recurrence. Preoperative botulinum toxin type A (BTX-A) injection has emerged as a novel intervention to optimize fascial closure by reducing abdominal wall muscle tension, facilitating surgical repair, and potentially decreasing postoperative complications.
objectiveTo evaluate the effect of preoperative BTX-A injection on fascial closure rates, postoperative complications, hernia recurrence, and hospital length of stay in patients undergoing repair of giant incisional hernias.
methodsA systematic review and meta-analysis were conducted according to PRISMA guidelines. Studies assessing the outcomes of BTX-A injection in the management of giant incisional hernias were included. The primary outcomes were the rate of complete fascial closure and hernia recurrence. Secondary outcomes included postoperative complications and length of hospital stay. Risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using a random-effects model.
resultsFive articles were selected and included in this systematic review. BTX-A injections showed a positive trend toward improved fascial closure in certain studies, although global analysis did not reveal statistically significant differences compared to controls (RR = 0.95; 95% CI: 0.90-1.01). There was no significant effect on hernia recurrence (RR = 1.02; 95% CI: 0.64-1.49). However, BTX-A significantly reduced postoperative complications (RR = 0.66; 95% CI: 0.50-0.88), with no meaningful reduction in the length of hospital stay (MD = -0.72 days; 95% CI: -1.8 to 0.36).
conclusionPreoperative BTX-A injection is a safe adjunct but has not shown significant benefits in improving fascial closure or reducing hernia recurrence. Although it reduces postoperative complications, its overall clinical impact is limited. Current evidence does not support its routine use, and further high-quality RCTs are needed.
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Registered trials
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