LAUSR

To describe and analyze the effectiveness of preconditioning complex abdominal wall with botulinum toxin type A (BTA) demonstrated by a preoperative electromyography. Descriptive and prospective study from September 2018 to November 2020 of our patients who received neoadjuvant BTA and an electromyographic study prior to complex eventroplasty surgery. The patients signed a specific informed consent and 500 U of BTA were administered on an outpatient regimen at 10 different points under ultrasound control. The BTA was administered ecoguide by the radiologist approximately one month (33.8 days) before surgery. The electromyographic study was performed 35 days after the administration. Demographic, pre-surgical, intra-surgical and post-surgical variables were studied. 57 received neoadjuvant BTA, 24 (42.1%) underwent an electromyographic study. The mean age were 64.8 years. The mean BMI was 29.3. The 24 patients (100%) had a W3 eventration of the EHS classification. Moderate (grade II) denervation was found in 7 patients (29.2%) and intense (grade III) in 17 patients (70.8%), according to neurophysiology criteria. No significant complications occurred in any patient. No complications were register. Eventroplasty was performed according to the Rives-Stoppa technique in 3 patients (12.5%) and according to the transversus abdominis release (TAR) technique in 21 (87.5%). The mean stay was 7.9 days. The electromyographic study in patients who have received BTA as neoadjuvant therapy for complex eventroplasties confirms the effectiveness of this therapy (100% presented denervation, >70% intense denervation), which clinically translates into less extensive dissections and better fascial closures with no significant complications.