Author:
Jonas J. P.,Rössler F.,Ghafoor S.,Kobe A.,Pfammatter T.,Schlag C.,Gutschow C. A.,Petrowsky H.,Müller P. C.,Oberkofler C. E.
Abstract
Abstract
Introduction
Compression syndromes of the celiac artery (CAS) or superior mesenteric artery (SMAS) are rare conditions that are difficult to diagnose; optimal treatment remains complex, and symptoms often persist after surgery. We aim to review the literature on surgical treatment and postoperative outcome in CAS and SMAS syndrome.
Methods
A systematic literature review of medical literature databases on the surgical treatment of CAS and SMAS syndrome was performed from 2000 to 2022. Articles were included according to PROSPERO guidelines. The primary endpoint was the failure-to-treat rate, defined as persistence of symptoms at first follow-up.
Results
Twenty-three studies on CAS (n = 548) and 11 on SMAS (n = 168) undergoing surgery were included. Failure-to-treat rate was 28% for CAS and 21% for SMAS. Intraoperative blood loss was 95 ml (0–217) and 31 ml (21–50), respectively, and conversion rate was 4% in CAS patients and 0% for SMAS. Major postoperative morbidity was 2% for each group, and mortality was described in 0% of CAS and 0.4% of SMAS patients. Median length of stay was 3 days (1–12) for CAS and 5 days (1–10) for SMAS patients. Consequently, 47% of CAS and 5% of SMAS patients underwent subsequent interventions for persisting symptoms.
Conclusion
Failure of surgical treatment was observed in up to every forth patient with a high rate of subsequent interventions. A thorough preoperative work-up with a careful patient selection is of paramount importance. Nevertheless, the surgical procedure was associated with a beneficial risk profile and can be performed minimally invasive.
Publisher
Springer Science and Business Media LLC
Reference52 articles.
1. Lipshutz B (1917) A composite study of the coeliac axis artery. Ann Surg 65(2):159–169
2. Harjola PT (1963) A rare obstruction of the coeliac artery. Report of a case. Ann Chir Gynaecol Fenn. 52:547–50
3. Dunbar JD, Molnar W, Beman FF, Marable SA (1965) Compression of the celiac trunk and abdominal angina. Am J Roentgenol Radium Ther Nucl Med 95(3):731–744
4. Kaur A, Pawar NC, Singla S, Mohi JK, Sharma S (2016) Superior mesentric artery syndrome in a patient with subacute intestinal obstruction: a case report. J Clin Diagn Res 10(6):TD03-5
5. Merrett ND, Wilson RB, Cosman P, Biankin AV (2009) Superior mesenteric artery syndrome: diagnosis and treatment strategies. J Gastrointest Surg 13(2):287–292