Podda Mauro, Gusai Gian Pietro, Balestra Francesco, Argenio Giulio, Pulighe Fabio, Di Saverio Salomone, De Nisco Carlo
Department of General, Emergency and Robotic Surgery, San Francesco Hospital, Italy.
Department of General and Oncological Surgery, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
Int J Med Robot. 2018 Aug;14(4):e1919. doi: 10.1002/rcs.1919. Epub 2018 May 9.
Median Arcuate Ligament Syndrome (MALS) is a rare clinical condition.
Through the analysis of a case report and a review of the international literature, we examined whether robotic and laparoscopic MAL release are safe and feasible.
Of 354 and 19 patients who underwent laparoscopic MAL release (LMALr) and robotic-assisted MAL release (RMALr), respectively, conversion to open surgery occurred in 6.8% of cases following LMALr, whereas no case of conversion was reported following RMALr. Immediate symptomatic improvement was reported in 92.1% of cases following LMALr and in 84.2% of cases following RMALr. In the LMALr group 9% of patients presented with recurrence of symptoms, whereas the percentage in the RMALr group was 5.3%. LMALr was related to a higher overall complication rate when compared with RMALr (7.3% vs 5.3%).
Both laparoscopic and robotic-assisted MAL lysis with celiac ganglionectomy can be safely performed with minimal patient morbidity.
正中弓状韧带综合征（MALS）是一种罕见的临床病症。
通过分析一份病例报告并回顾国际文献，我们研究了机器人辅助和腹腔镜下MAL松解术是否安全可行。
分别有354例和19例患者接受了腹腔镜下MAL松解术（LMALr）和机器人辅助MAL松解术（RMALr），LMALr术后6.8%的病例转为开放手术，而RMALr术后未报告有转为开放手术的病例。LMALr术后92.1%的病例和RMALr术后84.2%的病例报告有症状立即改善。LMALr组9%的患者出现症状复发，而RMALr组的这一比例为5.3%。与RMALr相比，LMALr的总体并发症发生率更高（7.3%对5.3%）。
腹腔镜和机器人辅助的MAL松解联合腹腔神经节切除术均能安全实施，对患者的发病率影响最小。
