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.	鄧鑫, 趙毅, 王強, 等. 十二指腸環形引流術治療腸系膜上動脈壓迫癥25例療效分析. 中國實用外科雜志, 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.	歐新元, 劉玉華, 張曉國. 腸系膜上動脈綜合征的術式選擇. 臨床外科雜志, 2000, 8(2): 90-91.
6.	岑川, 黃聰武. 腸系膜上動脈綜合征的臨床研究進展. 中國實用醫藥, 2010, 5(11): 244-247.
7.	楊維良, 張好剛. 腸系膜上動脈綜合征. 中國現代普通外科進展, 2010, 13(7): 505-508.
8.	李佑, 臧潞, 胡偉國. 腹腔鏡與開腹胃癌根治術治療早期胃癌的臨床對照研究. 中華胃腸外科雜志, 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, 王自強, 錢鋒, 等. 腹腔鏡輔助胃癌根治術105例. 中華外科雜志, 2006, 44(19): 1303-1306.
11.	池畔, 林惠銘, 徐宗斌. 腹腔鏡與開腹結直腸癌根治術圍手術期并發癥發生率比較. 中華胃腸外科雜志, 2006, 9(3): 221-224.
12.	熊治國, 殷濤, 崔殿生, 等. 腹腔鏡輔助近端胃癌根治術臨床近期療效. 中華腔鏡外科雜志(電子版), 2013, 6(1): 19-22.
13.	方國吉, 杜曉輝, 寧寧, 等. 腹腔鏡輔助與開腹遠端胃癌D2根治術近期康復的對比研究. 中華腔鏡外科雜志(電子版), 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.	劉勇, 羅羽宏. 腸系膜上動脈壓迫綜合征的診療進展. 中國普外基礎與臨床雜志, 2011, 18(2): 225-228.
17.	曾長青, 黃良祥, 李建黨. 腸系膜上動脈壓迫綜合征18例外科治療體會. 福建醫藥雜志, 2009, 31(5): 34-35.
18.	楊維良, 單世光, 賈洪波, 等. 腸系膜上動脈綜合征的外科治療. 中華普通外科雜志, 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.	楊維良. 腸系膜上動脈壓迫綜合征//王吉甫. 胃腸外科學. 北京: 人民衛生出版社, 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, 姜軍, 等. 頑固性便秘并發腸系膜上動脈綜合征的危險因素和營養支持治療效果分析. 中華胃腸外科雜志, 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. 鄧鑫, 趙毅, 王強, 等. 十二指腸環形引流術治療腸系膜上動脈壓迫癥25例療效分析. 中國實用外科雜志, 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. 歐新元, 劉玉華, 張曉國. 腸系膜上動脈綜合征的術式選擇. 臨床外科雜志, 2000, 8(2): 90-91.
6. 岑川, 黃聰武. 腸系膜上動脈綜合征的臨床研究進展. 中國實用醫藥, 2010, 5(11): 244-247.
7. 楊維良, 張好剛. 腸系膜上動脈綜合征. 中國現代普通外科進展, 2010, 13(7): 505-508.
8. 李佑, 臧潞, 胡偉國. 腹腔鏡與開腹胃癌根治術治療早期胃癌的臨床對照研究. 中華胃腸外科雜志, 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, 王自強, 錢鋒, 等. 腹腔鏡輔助胃癌根治術105例. 中華外科雜志, 2006, 44(19): 1303-1306.
11. 池畔, 林惠銘, 徐宗斌. 腹腔鏡與開腹結直腸癌根治術圍手術期并發癥發生率比較. 中華胃腸外科雜志, 2006, 9(3): 221-224.
12. 熊治國, 殷濤, 崔殿生, 等. 腹腔鏡輔助近端胃癌根治術臨床近期療效. 中華腔鏡外科雜志(電子版), 2013, 6(1): 19-22.
13. 方國吉, 杜曉輝, 寧寧, 等. 腹腔鏡輔助與開腹遠端胃癌D2根治術近期康復的對比研究. 中華腔鏡外科雜志(電子版), 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. 劉勇, 羅羽宏. 腸系膜上動脈壓迫綜合征的診療進展. 中國普外基礎與臨床雜志, 2011, 18(2): 225-228.
17. 曾長青, 黃良祥, 李建黨. 腸系膜上動脈壓迫綜合征18例外科治療體會. 福建醫藥雜志, 2009, 31(5): 34-35.
18. 楊維良, 單世光, 賈洪波, 等. 腸系膜上動脈綜合征的外科治療. 中華普通外科雜志, 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. 楊維良. 腸系膜上動脈壓迫綜合征//王吉甫. 胃腸外科學. 北京: 人民衛生出版社, 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, 姜軍, 等. 頑固性便秘并發腸系膜上動脈綜合征的危險因素和營養支持治療效果分析. 中華胃腸外科雜志, 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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