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肠系膜上动脉综合征真的可以手术治疗吗?

Can superior mesenteric artery syndrome really be treated surgically?

出版信息

Ann Ital Chir. 2020;91:35-40.

Abstract

AIM

Superior mesenteric artery (SMA) syndrome is a rare reason of small bowel obstruction (SBO). İt is a complicated sickness. We aim to analyze the diagnosis, clinical presentation, SMAS management and postoperative outcomes after laparoscopic duodenojejunostomy.

MATERIAL AND METHODS

A total of 19 patients who were diagnosed with SMAS and did not respond to the traditional treatment between January 2010 and November 2017 in Afyon Health Sciences University Hospital were included in the study.

RESULTS

Their average age was 22.3 years (17-31 years). Number of males and females were 6 and 13, respectively. Clinical presentations of patients are as follow: 14 patients were referred to as postprandial distress syndrome, 3 were unexplained weight loss, and 2 were gastroesophageal reflux disease. Considering CT angiography findings, 14 patients had duodenal dilatation. The mean aortamesenteric angle was 10.6 mm. The mean of aorta-SMA distance was 5.1 mm. The mean hospital stay and follow-up times were 3.7 days and 40.2 months, respectively. No morbidity or mortality was found within patients. Preoperative, postoperative 6th month and postoperative 12th month CONUT scores were 9.1, 3.7, and 0.8, respectively.

CONCLUSIONS

Laparoscopic duodenojejunostomy can be performed safely to the patients who do not benefit from conservative treatment.

KEY WORDS

Aortamesenteric angle, Duodenojejunostomy, Weight loss.

摘要

目的

肠系膜上动脉(SMA)综合征是一种罕见的小肠梗阻(SBO)原因。它是一种复杂的疾病。我们旨在分析腹腔镜十二指肠胃肠吻合术治疗后诊断、临床表现、SMA 管理和术后结果。

材料和方法

2010 年 1 月至 2017 年 11 月,在阿夫永健康科学大学医院诊断为 SMA 且对传统治疗无反应的 19 例患者纳入本研究。

结果

他们的平均年龄为 22.3 岁(17-31 岁)。男女分别为 6 例和 13 例。患者的临床表现如下:14 例为餐后不适综合征,3 例为不明原因体重减轻,2 例为胃食管反流病。考虑 CT 血管造影结果,14 例患者有十二指肠扩张。主动脉肠系膜夹角平均为 10.6 毫米。主动脉-SMA 距离平均为 5.1 毫米。平均住院时间和随访时间分别为 3.7 天和 40.2 个月。患者无发病率或死亡率。术前、术后第 6 个月和术后第 12 个月的 CONUT 评分分别为 9.1、3.7 和 0.8。

结论

对于保守治疗无效的患者,腹腔镜十二指肠胃肠吻合术可以安全进行。

关键词

主动脉肠系膜夹角;十二指肠胃肠吻合术;体重减轻。

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