Bahadir Kutay, Ünal Demet Sarıdemir, Ural Selin, Sacın Yunus Emre, Keven Ayse, Karaguzel Gungor, Mesci Ayhan
Akdeniz University, School of Medicine, Department of Pediatric Surgery - Antalya, Turkey.
Akdeniz University, School of Medicine, Department of General Surgery - Antalya, Turkey.
Rev Assoc Med Bras (1992). 2025 Sep 19;71(8):e20250082. doi: 10.1590/1806-9282.20250082. eCollection 2025.
Median arcuate ligament syndrome is a rare pathology where the median arcuate ligament causes compression on the celiac trunk. Different techniques are utilized in the treatment of median arcuate ligament syndrome, and studies on a standard laparoscopic technique are limited. The aim of this study is to evaluate the surgical and clinical outcomes of patients who underwent laparoscopic "antegrade" release of median arcuate ligament in a single tertiary center.
This retrospective study includes nine adolescents/young adults who underwent laparoscopy for median arcuate ligament syndrome between 2016 and 2024. All laparoscopic procedures were performed with an antegrade approach. The patients' demographic data, symptoms, radiologic imaging methods, operative technique, and postoperative outcomes were recorded.
There were seven female and two male patients in our series. The median age at diagnosis was 17 (range: 15-26) years. The most common symptoms were postprandial abdominal pain (n=9), nausea and vomiting (n=8), and weight loss (n=7). Doppler ultrasonography and/or computed tomography angiography (n=9, 100%) were performed in all patients as preoperative diagnostic imaging. The mean operation time was 92 (range: 60-110) min. The mean oral intake time was 1.2 (range: 1-3) days. The mean hospitalization time was 3 (range: 2-5) days. There was no conversion to laparotomy. One patient had a recurrence during follow-up and underwent a secondary intervention. The mean follow-up time was 62.6 (3-88) months.
Laparoscopic median arcuate ligament release with an antegrade approach is safe and feasible to perform and adequate in terms of symptom relief and celiac artery compression release in both adolescent and young adult groups.
正中弓状韧带综合征是一种罕见的病理状况，即正中弓状韧带对腹腔干造成压迫。治疗正中弓状韧带综合征采用了不同的技术，而关于标准腹腔镜技术的研究有限。本研究的目的是评估在单一三级中心接受腹腔镜“顺行”松解正中弓状韧带的患者的手术和临床结果。
这项回顾性研究纳入了2016年至2024年间因正中弓状韧带综合征接受腹腔镜手术的9名青少年/青年。所有腹腔镜手术均采用顺行入路。记录患者的人口统计学数据、症状、放射学成像方法、手术技术和术后结果。
我们的系列中有7名女性和2名男性患者。诊断时的中位年龄为17岁（范围：15 - 26岁）。最常见的症状是餐后腹痛（n = 9）、恶心和呕吐（n = 8）以及体重减轻（n = 7）。所有患者均进行了多普勒超声检查和/或计算机断层血管造影（n = 9，100%）作为术前诊断性成像。平均手术时间为92分钟（范围：60 - 110分钟）。平均经口进食时间为1.2天（范围：1 - 3天）。平均住院时间为3天（范围：2 - 5天）。无中转开腹情况。1例患者在随访期间复发并接受了二次干预。平均随访时间为62.6个月（3 - 88个月）。
采用顺行入路的腹腔镜正中弓状韧带松解术在青少年和青年组中进行是安全可行的，在缓解症状和解除腹腔动脉压迫方面是足够的。
