Laparoscopic Duodenojejunostomy for the Treatment of Superior Mesenteric Artery Syndrome: Analysis of 91 Patients
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Tarih
2025-02-14
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Springer Science and Business Media LLC
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Superior mesenteric artery syndrome (SMAS) is a rare condition caused by the compression of the third portion of the duodenum between the aorta and the superior mesenteric artery (SMA). Laparoscopic duodenojejunostomy has emerged as a safe and effective surgical treatment, particularly when conservative measures fail. We analyzed the clinical and surgical outcomes of 91 patients who underwent laparoscopic duodenojejunostomy for SMAS between February 2016 and July 2023. Preoperative clinical characteristics, surgical data, postoperative symptom improvement rates, and weight regain were evaluated. Diagnosis was confirmed through computed tomographic angiography (CTA), demonstrating an aortomesenteric angle < 20 degrees and distance < 10 mm. Conservative treatment was initially applied in all cases prior to surgical intervention. Among the 91 patients, 58.2% were female, and the mean age was 29.2 SD 11 years. All surgeries were completed laparoscopically with no intraoperative complications. After an average follow-up of 42.5 SD 26.7 months, 93.4% of patients showed significant symptom improvement, with a mean postoperative weight gain of 4.5 SD 2.5 kg. Postoperative complications included delayed gastric emptying in 8 patients (resolved conservatively) and low-output chylous fistulas in 4 patients (resolved spontaneously). There was no mortality. Laparoscopic duodenojejunostomy is a safe and effective treatment for SMAS, offering high success rates and minimal complications. While this study highlights the benefits of a multidisciplinary approach and standardized surgical techniques, further prospective studies are needed to optimize management protocols for this rare condition.
Açıklama
Anahtar Kelimeler
Superior mesenteric artery syndrome, Wilkie's syndrome, Laparoscopic duodenojejunostomy, Aortomesenteric angle
Kaynak
Indian Journal of Surgery
WoS Q Değeri
Q4
Scopus Q Değeri
Cilt
Sayı
Künye
Yetişir, F., Çelik, M. E., Taşkın, Y. E., Özdemir, O., Kurt, Ö., Tiken, R., & Yüksel, O. (2025). Laparoscopic Duodenojejunostomy for the Treatment of Superior Mesenteric Artery Syndrome: Analysis of 91 Patients. Indian Journal of Surgery, 1-8.
