腹腔动脉压迫综合征中腹腔动脉减压术的详细解剖和步骤。
Detailed anatomy and procedure of celiac artery decompression in median arcuate ligament syndrome.
机构信息
Hepato-Biliary Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
出版信息
Langenbecks Arch Surg. 2021 Aug;406(5):1717-1722. doi: 10.1007/s00423-021-02195-9. Epub 2021 May 13.
PURPOSE
Median arcuate ligament (MAL) syndrome is a clinical syndrome caused by the compression of the celiac artery (CA) by the MAL. This study aimed to present the detailed anatomy and a step-by-step procedure of CA decompression for MAL syndrome.
METHODS
The CA decompression procedure involves exposing the diaphragmatic crura and aorta, taping the left gastric artery, and dividing the compressive tissues. The MAL and ganglionic tissue, which form a broad band with multiple layers overlying the CA, comprise the compressive tissues. Therefore, the compressive tissues overlying the CA are encircled and divided one by one until the CA stenosis is released. CA decompression is confirmed with intraoperative duplex ultrasonography of the CA, with a return to normal peak systolic velocities without variation between deep inspiration and expiration.
CONCLUSION
This report presents the detailed anatomy and procedural steps for CA decompression in MAL syndrome.
目的
中位弓状韧带（MAL）综合征是由 MAL 压迫腹腔动脉（CA）引起的临床综合征。本研究旨在介绍 MAL 综合征的 CA 减压的详细解剖结构和逐步操作步骤。
方法
CA 减压过程包括暴露膈肌脚和主动脉，绑住胃左动脉，并分割压迫组织。 MAL 和神经节组织构成了覆盖 CA 的多层宽带状结构，是压迫组织。因此，环绕并逐一分割覆盖 CA 的压迫组织，直到 CA 狭窄得到释放。通过 CA 的术中双功能超声检查确认 CA 减压，收缩期峰值速度恢复正常，深吸气和呼气之间没有变化。
结论
本报告介绍了 MAL 综合征中 CA 减压的详细解剖结构和操作步骤。
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