P-038 BOTULINUM TOXIN IN THE TREATMENT OF COMPLEX ABDOMINAL HERNIAS: A REVIEW OF CLINICAL OUTCOMES

Abstract

Abstract Aim Adjuvant use of botulinum toxin (BTX), which causes temporary paralysis of the lateral abdominal wall muscles, may have a roll in achieving a functional abdominal wall reconstruction when treating complex hernias, without the need of component separation techniques (CST). Methods Retrospective analysis of all patients with complex hernia between April 2021 and October 2022 in which BTX was used. Patients that would have to go through CST regardless and patients with other adjuvant treatments were excluded. Results 22 patients had BTX, with a total of 13 patients included in this study. The median age was 64 and BMI 30,7kg/m2. The average CT imaging measurement of the transverse defect was 13,7cm. The median of Cedar's calculation was 27%. 7 patients (54%) only needed a Rives Stoppa Wantz (RSW) for midline closure, but 6 patients still needed a CST. The median time of the surgery for the RSW was 233 min and for the CST 330 min. Of the patients submitted to RSW, 1 complicated with a deep incisional infection and 2 CST patients had surgical complications. No recurrences in the RSW group and one hernia persistence after a major complication on the CST group. Conclusion The BTX can have an important role as an adjuvant in the treatment of large incisional hernias and in some patients may allow its repair with a less invasive surgical technique, with less operative time and less complications. More studies are needed in this area.