METHODS: Materials and Methods: The prospective study included 59 patients with large VH (defect ³10 cm). All patients received 100 IU of BTA in abdominal wall muscles 4-5 weeks before surgery from June 2017 to December 2022. An average age of the patients was 59.13 ± 9.07 years, body mass index - 32.20 ± 4.95 kg/m2.
RESULTS: Results: An average width of the hernia defect after BTA decreased by 4.5 ± 1.11 cm (p<0.001). An average length of the hernia defect after BTA also decreased, without clinical significance. A significant increase in the length of the abdominal wall and a decrease in its thickness were observed. The abdominal cavity volume after BTA increased by 4.04 ± 4.55% (p=0.008) and the hernial sac volume decreased by 21.43 ± 16.57% (p=0.005). All patients underwent surgery with hernia defect suturing and without component separation: laparoscopic IPOM hernioplasty - 50 (84.7%) patients, open IPOM hernia repair - 7 (11.9%) patients, open sublay hernioplasty - 2 (3.4%) patients. There was no recurrence of hernia during 12 months after surgery.
CONCLUSIONS: Conclusions: The administration of 100 IU BTA allows to increase the length of the abdominal wall muscles and to perform laparoscopic IPOM hernioplasty for patients with large VH.
方法:材料和方法:前瞻性研究包括59例大VH(缺陷为10厘米)患者。从2017年6月至2022年12月,所有患者在手术前4-5周接受腹壁肌肉100IU的BTA。患者平均年龄为59.13±9.07岁,体重指数-32.20±4.95kg/m2。
结果:结果:BTA后疝缺损的平均宽度减少了4.5±1.11cm(p<0.001)。BTA术后疝缺损的平均长度也减少,无临床意义。观察到腹壁长度的显着增加和厚度的减少。BTA后腹腔容积增加4.04±4.55%(p=0.008),疝囊容积减少21.43±16.57%(p=0.005)。所有患者均接受了疝缺损缝合和无组件分离的手术:腹腔镜IPOM疝修补术-50(84.7%)患者,开放式IPOM疝修补术-7例(11.9%)患者,开放式下疝修补术-2例(3.4%)患者。术后12个月无疝气复发。
结论:结论:100IUBTA的给药可以增加腹壁肌肉的长度,并对大VH患者进行腹腔镜IPOM疝修补术。