Dordoni L, Tshomba Y, Giacomelli M, Jannello A M, Chiesa R
Chirurgia Vascolare, IRCCS Ospedale San Raffaele Università Vita e Salute, Milan.
Vasc Endovascular Surg. 2002 Jul-Aug;36(4):317-21. doi: 10.1177/153857440203600411.
Several authors believe the crus of the diaphragm or the arcuate ligament is largely implicated in the etiology of the celiac artery compression syndrome (CACS). An unusual case of CACS successfully treated with laparoscopic decompression is reported. While under general anesthesia, the patient underwent laparoscopic division of the hypertrophic median arcuate ligament and dissection free of the celiac trunk. Postoperative angiography demonstrated improved flow in the celiac artery. The patient was discharged on the second postoperative day. At 6 months, Doppler ultrasound scanning and magnetic resonance angiography revealed good patency of the celiac trunk. The patient reported complete resolution of symptoms and increased weight. A laparoscopic approach allows the surgeon to sufficiently dissect the celiac axis. An excellent clinical result at short-term follow-up was attained. This is the second reported experience with this new procedure and the first successfully performed with only four port sites.
几位作者认为，膈肌脚或弓状韧带在腹腔干压迫综合征（CACS）的病因中起主要作用。本文报道了一例通过腹腔镜减压成功治疗的罕见CACS病例。在全身麻醉下，患者接受了腹腔镜下肥厚正中弓状韧带松解术及腹腔干游离术。术后血管造影显示腹腔干血流改善。患者术后第二天出院。6个月时，多普勒超声扫描和磁共振血管造影显示腹腔干通畅良好。患者报告症状完全缓解且体重增加。腹腔镜手术方法使外科医生能够充分游离腹腔干。短期随访取得了优异的临床效果。这是该新手术方法的第二例报道经验，也是首例仅通过四个穿刺孔成功实施的手术。
