目标:肠系膜上动脉综合征(SMAS)是慢性十二指肠阻塞的罕见病因之一。我们研究的目的是评估过去十年来我们机构难治性SMAS(Re-SMAS)手术治疗的结果。
方法:回顾性纳入连续诊断为Re-SMAS并接受手术干预的患者。使用改良的基于Likert量表的问卷来量化SMAS的症状。主要结果是BMI的增加和手术后症状的缓解。
结果:2010年1月至2020年1月,纳入22例诊断为Re-SMAS并接受手术的患者。纳入患者年龄分布<19(10/22,45%),19-45(11/22,50%),和>45(1/22,5%)。记录到BMI显著增加,[16.1(14.6-23.7)kg/m2vs手术前后21.9(15.6-29.5)kg/m2,分别,p<0.001]。多达20名患者(20/22,91%)报告症状缓解。梗阻相关症状评分显著下降(p<0.001),报告有恶心,呕吐,反流发生率从77%下降到41%(p=0.031),68%到23%(p=0.006),和32%至5%(p=0.046),分别。
结论:手术干预可以缓解Re-SMAS的梗阻相关症状并促进体重增加。对于患有Re-SMAS并主要因梗阻相关症状而转诊给外科医生的患者,建议进行手术干预。
Superior mesenteric artery syndrome (SMAS) is one of the rare causes of chronic duodenal obstruction. The aim of our study was to evaluate the outcomes of surgical management of refractory SMAS (Re-SMAS) in our institution during the last decade.
Consecutive patients diagnosed as Re-SMAS and underwent surgical intervention were retrospectively enrolled. A modified Likert-scale-based questionnaire was used to quantify the symptoms of SMAS. The primary outcome was the increase of BMI and symptomatic relief after surgery.
From January 2010 to January 2020, 22 patients diagnosed with Re-SMAS and underwent surgery were included. Age distribution of included patients were < 19 (10/22, 45%), 19-45 (11/22, 50%), and > 45 (1/22, 5%). A significant BMI increase was recorded, [16.1 (14.6-23.7) kg/m2 vs 21.9 (15.6-29.5) kg/m2 before and after surgery, respectively, p < 0.001]. Up to 20 patients (20/22, 91%) reported symptomatic relief. The obstruction-related symptom score decreasing significantly (p < 0.001), with reported nausea, vomiting, and regurgitation incidences dropping from 77 to 41% (p = 0.031), 68 to 23% (p = 0.006), and 32 to 5% (p = 0.046), respectively.
Surgical interventions could relieve obstruction-related symptoms of Re-SMAS and promote weight gain. For patients who suffered from Re-SMAS and referred to surgeons mainly for obstruction-related symptoms, surgical intervention is recommended.