Comparison of laparoscopic and open duodenal circular drainage operation for superior mesenteric artery compressing syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GUO Lin , LIU Xing ,  SUN Wei

Department of Gastroduodenal and Nutriology Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, P.R.China;

Corresponding author：

SUN Wei, Email: 6162679@qq.com

Keywords：

superior mesenteric artery compressing syndrome; laparoscope; duodenal circular drainage operation; clinical efficacy

DOI：

10.7507/1007-9424.201606063

Video：

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Objective To compare efficacy of laparoscopic and open duodenal circular drainage operation for superior mesenteric artery compressing syndrome (SMACS). Methods From December 2012 to December 2015, the clinical data of 23 cases of laparoscopic duodenal circular drainage operation (laparoscope group) and 28 cases of open duodenal circular drainage operation (open group) were analyzed. The operation time, intraoperative bleeding, postoperative ambulation time, postoperative analgesics usage, postoperative the first exhaust time, postoperative the first feeding time, postoperative hospitalization time and postoperative incidence of complications were compared. The patients were followed up to confirm the effect after the operation. Results There were no differences of the age, sex, and body weight index between the laparoscope group and the open group (P>0.05). The operation time had no significant difference between these two groups (P>0.05). Compared with the open group, the intraoperative bleeding was less (P<0.05), the postoperative ambulation time, postoperative the first exhaust time, postoperative the first feeding time, postoperative hospitalization time were shorter (P<0.05), the rates of postoperative analgesics usage, incision infection, pulmonary infection, and intestinal obstruction were lower (P<0.05) in the laparoscope group. The rates of anastomotic leakage and anastomotic bleeding, and total postoperative complications rate had no significant differences between these two groups (P>0.05). All the patients were followed up for 8–36 months. The clinical symptoms disappeared and the body weight increased to normal level in the two groups. Conclusions Preliminary results of in this study show that laparoscopic duodenal circular drainage operation in treatment of SMACS has some advantages such as less trauma, faster recovery, fewer complications and shorter hospitalization time. Laparoscopy will be an ideal choice for treatment of SMACS.

Citation： GUOLin, LIUXing, SUNWei. Comparison of laparoscopic and open duodenal circular drainage operation for superior mesenteric artery compressing syndrome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(2): 210-214. doi: 10.7507/1007-9424.201606063 Copy

1.	Smith BG, Hakim-Zargar M, Thomson JD. Low body mass index: a risk factor for superior mesenteric artery syndrome in adolescents undergoing spinal fusion for scoliosis. J Spinal Disord Tech, 2009, 22(2): 144-148.
2.	Rioualen S, Lavenant P, Delpeut J,et al. Superior mesenteric artery syndrome or Wilkie’s syndrome. Arch Pediatr, 2016, 23(7): 769-771.
3.	邓鑫, 赵毅, 王强, 等. 十二指肠环形引流术治疗肠系膜上动脉压迫症25例疗效分析. 中国实用外科杂志, 2014, 34(6): 556-557.
4.	Oguz A, Uslukaya O, Ülger BV,et al. Superior mesenteric artery (Wilkie’s) syndrome: a rare cause of upper gastrointestinal system obstruction. Acta Chir Belg, 2016, 116(2): 81-88.
5.	欧新元, 刘玉华, 张晓国. 肠系膜上动脉综合征的术式选择. 临床外科杂志, 2000, 8(2): 90-91.
6.	岑川, 黄聪武. 肠系膜上动脉综合征的临床研究进展. 中国实用医药, 2010, 5(11): 244-247.
7.	杨维良, 张好刚. 肠系膜上动脉综合征. 中国现代普通外科进展, 2010, 13(7): 505-508.
8.	李佑, 臧潞, 胡伟国. 腹腔镜与开腹胃癌根治术治疗早期胃癌的临床对照研究. 中华胃肠外科杂志, 2010, 13(12): 899-902.
9.	Yang WL, Zhang XC. Assessment of duodenal circular drainage in treatment of superior mesenteric artery syndrome. World J Gastroenterol, 2008, 14(2): 303-306.
10.	余佩武, 王自强, 钱锋, 等. 腹腔镜辅助胃癌根治术105例. 中华外科杂志, 2006, 44(19): 1303-1306.
11.	池畔, 林惠铭, 徐宗斌. 腹腔镜与开腹结直肠癌根治术围手术期并发症发生率比较. 中华胃肠外科杂志, 2006, 9(3): 221-224.
12.	熊治国, 殷涛, 崔殿生, 等. 腹腔镜辅助近端胃癌根治术临床近期疗效. 中华腔镜外科杂志(电子版), 2013, 6(1): 19-22.
13.	方国吉, 杜晓辉, 宁宁, 等. 腹腔镜辅助与开腹远端胃癌D2根治术近期康复的对比研究. 中华腔镜外科杂志(电子版), 2013, 6(1): 23-25.
14.	Kaur A, Pawar NC, Singla S,et al. Superior mesenteric artery syndrome in a patient with subacute intestinal obstruction: a case report. J Clin Diagn Res, 2016, 10(6): TD03-TD05.
15.	Lee AM, Bai HX, Zou YJ,et al. Superior Mesenteric artery syndrome in a 20-year-old athletic female with abdominal pain. Chin Med J, 2015, 128(23): 3260-3261.
16.	刘勇, 罗羽宏. 肠系膜上动脉压迫综合征的诊疗进展. 中国普外基础与临床杂志, 2011, 18(2): 225-228.
17.	曾长青, 黄良祥, 李建党. 肠系膜上动脉压迫综合征18例外科治疗体会. 福建医药杂志, 2009, 31(5): 34-35.
18.	杨维良, 单世光, 贾洪波, 等. 肠系膜上动脉综合征的外科治疗. 中华普通外科杂志, 1998, 13(5): 308-310.
19.	Cullis PS, Gallagher M, Sabharwal AJ,et al. Minimally invasive surgery for superior mesenteric artery syndrome: a case report and literature review. Scott Med J, 2016, 61(1): 42-47.
20.	Yao SY, Mikami R, Mikami S. Minimally invasive surgery for superior mesenteric artery syndrome: A case report. World J Gastroenterol, 2015, 21(45): 12970-12975.
21.	杨维良. 肠系膜上动脉压迫综合征//王吉甫. 胃肠外科学. 北京: 人民卫生出版社, 2000: 423-432.
22.	Gebhart T. Superior mesenteric artery syndrome. Gastroenterol Nurs, 2015, 38(3): 189-193.
23.	Abol Oyoun N, Kadhim M, Dormans JP. Late-onset superior mesenteric artery syndrome four years following scoliosis surgery—a case report. SICOT J, 2015, 1: 12.
24.	Pottorf BJ, Husain FA, Hollis HW Jr,et al. Laparoscopic management of duodenal obstruction resulting from superior mesenteric artery syndrome. JAMA Surg, 2014, 149(12): 1319-1322.
25.	徐琳, 虞文魁, 姜军, 等. 顽固性便秘并发肠系膜上动脉综合征的危险因素和营养支持治疗效果分析. 中华胃肠外科杂志, 2014, 17(10): 972-976.

1. Smith BG, Hakim-Zargar M, Thomson JD. Low body mass index: a risk factor for superior mesenteric artery syndrome in adolescents undergoing spinal fusion for scoliosis. J Spinal Disord Tech, 2009, 22(2): 144-148.
2. Rioualen S, Lavenant P, Delpeut J,et al. Superior mesenteric artery syndrome or Wilkie’s syndrome. Arch Pediatr, 2016, 23(7): 769-771.
3. 邓鑫, 赵毅, 王强, 等. 十二指肠环形引流术治疗肠系膜上动脉压迫症25例疗效分析. 中国实用外科杂志, 2014, 34(6): 556-557.
4. Oguz A, Uslukaya O, Ülger BV,et al. Superior mesenteric artery (Wilkie’s) syndrome: a rare cause of upper gastrointestinal system obstruction. Acta Chir Belg, 2016, 116(2): 81-88.
5. 欧新元, 刘玉华, 张晓国. 肠系膜上动脉综合征的术式选择. 临床外科杂志, 2000, 8(2): 90-91.
6. 岑川, 黄聪武. 肠系膜上动脉综合征的临床研究进展. 中国实用医药, 2010, 5(11): 244-247.
7. 杨维良, 张好刚. 肠系膜上动脉综合征. 中国现代普通外科进展, 2010, 13(7): 505-508.
8. 李佑, 臧潞, 胡伟国. 腹腔镜与开腹胃癌根治术治疗早期胃癌的临床对照研究. 中华胃肠外科杂志, 2010, 13(12): 899-902.
9. Yang WL, Zhang XC. Assessment of duodenal circular drainage in treatment of superior mesenteric artery syndrome. World J Gastroenterol, 2008, 14(2): 303-306.
10. 余佩武, 王自强, 钱锋, 等. 腹腔镜辅助胃癌根治术105例. 中华外科杂志, 2006, 44(19): 1303-1306.
11. 池畔, 林惠铭, 徐宗斌. 腹腔镜与开腹结直肠癌根治术围手术期并发症发生率比较. 中华胃肠外科杂志, 2006, 9(3): 221-224.
12. 熊治国, 殷涛, 崔殿生, 等. 腹腔镜辅助近端胃癌根治术临床近期疗效. 中华腔镜外科杂志(电子版), 2013, 6(1): 19-22.
13. 方国吉, 杜晓辉, 宁宁, 等. 腹腔镜辅助与开腹远端胃癌D2根治术近期康复的对比研究. 中华腔镜外科杂志(电子版), 2013, 6(1): 23-25.
14. Kaur A, Pawar NC, Singla S,et al. Superior mesenteric artery syndrome in a patient with subacute intestinal obstruction: a case report. J Clin Diagn Res, 2016, 10(6): TD03-TD05.
15. Lee AM, Bai HX, Zou YJ,et al. Superior Mesenteric artery syndrome in a 20-year-old athletic female with abdominal pain. Chin Med J, 2015, 128(23): 3260-3261.
16. 刘勇, 罗羽宏. 肠系膜上动脉压迫综合征的诊疗进展. 中国普外基础与临床杂志, 2011, 18(2): 225-228.
17. 曾长青, 黄良祥, 李建党. 肠系膜上动脉压迫综合征18例外科治疗体会. 福建医药杂志, 2009, 31(5): 34-35.
18. 杨维良, 单世光, 贾洪波, 等. 肠系膜上动脉综合征的外科治疗. 中华普通外科杂志, 1998, 13(5): 308-310.
19. Cullis PS, Gallagher M, Sabharwal AJ,et al. Minimally invasive surgery for superior mesenteric artery syndrome: a case report and literature review. Scott Med J, 2016, 61(1): 42-47.
20. Yao SY, Mikami R, Mikami S. Minimally invasive surgery for superior mesenteric artery syndrome: A case report. World J Gastroenterol, 2015, 21(45): 12970-12975.
21. 杨维良. 肠系膜上动脉压迫综合征//王吉甫. 胃肠外科学. 北京: 人民卫生出版社, 2000: 423-432.
22. Gebhart T. Superior mesenteric artery syndrome. Gastroenterol Nurs, 2015, 38(3): 189-193.
23. Abol Oyoun N, Kadhim M, Dormans JP. Late-onset superior mesenteric artery syndrome four years following scoliosis surgery—a case report. SICOT J, 2015, 1: 12.
24. Pottorf BJ, Husain FA, Hollis HW Jr,et al. Laparoscopic management of duodenal obstruction resulting from superior mesenteric artery syndrome. JAMA Surg, 2014, 149(12): 1319-1322.
25. 徐琳, 虞文魁, 姜军, 等. 顽固性便秘并发肠系膜上动脉综合征的危险因素和营养支持治疗效果分析. 中华胃肠外科杂志, 2014, 17(10): 972-976.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of laparoscopic and open duodenal circular drainage operation for superior mesenteric artery compressing syndrome

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