Ventral hernia secondary to giant omphalocele in a child: combined approach of botulinum toxin and preoperative progressive pneumoperitoneum

Rombaldi, Marcelo Costamilan; Neto, Wilson F S; Holanda, Felipe Colombo de; Cavazzola, Leandro Totti; Fraga, José Carlos Soares de

doi:10.1007/s10029-019-02084-7

Cited by 10 publications

(13 citation statements)

References 9 publications

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“…The combination of BTA and PPP in adults with large ventral hernias has clearly proven its benefits [ 13 , 14 ] but the use of this technique in children was previously described by our center as being the first reported case in the indexed literature [ 5 ]. BTA application seems safe in children, but until now, no accurate dose is known for abdominal wall usage [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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Complex ventral hernia repair in a child: An association of botulinum toxin, progressive pneumoperitoneum and negative pressure therapy. A case report on an arising surgical technique

Rombaldi

Barreto

Peterson

et al. 2021

International Journal of Surgery Case Reports

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Highlights Giant omphalocele establish a therapeutic challenge to the surgeon - mainly because of the increased visceroabdominal disproportion and underlying malformations - and the best approach is still debatable worldwide. This is the second report on the literature and states the management of a child born with giant omphalocele that developed a very complex ventral hernia secondary to an unsuccessful attempt of closing the primary defect. It seems that the use of botulinum toxin agents in the abdominal wall is safe and effective in children with giant omphaloceles and it eliminates the use of a mesh even in more difficult cases. This technique seems safe and effective and it should be encouraged and best evaluated. It is time to start defining better criteria to categorize giant omphalocele in order to choose the best management for each patient.

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Section: Discussionmentioning

confidence: 99%

“…Recently, our center reported a combined approach of botulinum toxin agent (BTA) applied to the abdominal wall and preoperative progressive pneumoperitoneum (PPP) in a child with GO [ 5 ]. This technique showed to be feasible and safe.…”

Section: Introductionmentioning

confidence: 99%

Complex ventral hernia repair in a child: An association of botulinum toxin, progressive pneumoperitoneum and negative pressure therapy. A case report on an arising surgical technique

Rombaldi

Barreto

Peterson

et al. 2021

International Journal of Surgery Case Reports

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“…A total of 17 papers were reviewed. One case report described the treatment of a POVH in a 7-year-old child [5]. All other papers referred to the treatment of CIH in adults (11 retrospective [1, 4, 7-15] and 2 prospective [16,17] and 2 reviews [2,18].…”

Section: Bti Previous To the Repair Of Cihmentioning

confidence: 99%

“…PPP was done with daily injections of air for 2 weeks through a 7-Fr permanent catheter (initiating 2 weeks after BTI). The total volume (about 2000 ml) was controlled by the level of the patient's discomfort [5]. An analysis of the paper suggests that the dose of BT used was proportionally higher than the doses used in adults (see Table 2) and higher than the maximum recommended pediatric doses (maximal dose of 8 IU/kg or 300 IU) recommended by the US Food and Drug Administration (FDA) [27].…”

Section: Povh In Childrenmentioning

confidence: 99%

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Botulinum toxin abdominal wall injection and post-omphalocele ventral hernia repair: database and proposal of a protocol

et al. 2020

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Background Post-omphalocele ventral hernias (POVH) are common after giant omphaloceles. Abdominal wall botulinum toxin injections (BTI) are useful to treat complex incisional hernias (CIH) in adults, which may also apply to POVH. We review BTI data in the treatment of CIH and POVH and propose an algorithm applicable to POVH. Results Sixteen papers which described the treatment of CIH on the treatment of POVH in adults (n = 15) and children (n = 1) were reviewed. BTI elongates the lateral abdominal wall and reduces the hernia defect, with a lower incidence of compartment syndrome and respiratory complications. Doses and injection volumes vary. Effects start after 3 days, peak after 10–15 days, stabilize for 2–3 months, and decline after 4–6 months, disappearing after 6–9 months. Patients should be operated on 3–4 weeks after injection. Post-operative complications are uncommon. BTI may be associated with pre-operative pneumoperitoneum (PPP). Children presenting POVH differ from adults presenting CIH. Associated congenital cardiac malformations, genetically determined syndromes, pulmonary hypoplasia, abdominal wall hypoplasia, and thoracic dysmorphism, are common; children need sedation for any procedures; non-absorbable reinforcing meshes are not indicated; and POVH limits are frequently near to the costal margin. Conclusion BTI to induce preoperative muscular relaxation in preparation of CIH repair in adults is effective and safe. Experience with the method in children with POVH is limited, but the proposal is logical and probably safe. POVH differs from CIH in some aspects, especially abdominal wall hypoplasia, proximity to the rib cage, and diaphragmatic biomechanics.

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Giant omphalocele closure utilizing botulinum toxin

Rauh

Sieren

2020

Journal of Pediatric Surgery Case Reports

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Ventral hernia secondary to giant omphalocele in a child: combined approach of botulinum toxin and preoperative progressive pneumoperitoneum

Cited by 10 publications

References 9 publications

Complex ventral hernia repair in a child: An association of botulinum toxin, progressive pneumoperitoneum and negative pressure therapy. A case report on an arising surgical technique

Complex ventral hernia repair in a child: An association of botulinum toxin, progressive pneumoperitoneum and negative pressure therapy. A case report on an arising surgical technique

Botulinum toxin abdominal wall injection and post-omphalocele ventral hernia repair: database and proposal of a protocol

Giant omphalocele closure utilizing botulinum toxin

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