Can superior mesenteric artery syndrome really be treated surgically?

Area of Science:

• Gastroenterology
• Surgical Innovation
• Abdominal Surgery

Background:

• Superior Mesenteric Artery (SMA) syndrome is a rare cause of small bowel obstruction (SBO).
• Conservative treatments are often insufficient for managing SMA syndrome.
• Key indicators include aortamesenteric angle and aorta-SMA distance.

Purpose of the Study:

• To analyze the diagnosis, clinical presentation, management, and outcomes of SMA syndrome.
• To evaluate the efficacy and safety of laparoscopic duodenojejunostomy for SMA syndrome.
• To assess postoperative recovery and nutritional status (CONUT scores).

Main Methods:

• A retrospective study of 19 patients with SMA syndrome unresponsive to conservative treatment.
• Patients underwent laparoscopic duodenojejunostomy between January 2010 and November 2017.
• Data collected included clinical presentation, CT angiography, hospital stay, follow-up duration, and CONUT scores.

Main Results:

• The average patient age was 22.3 years, with a female predominance (13/19).
• Common presentations included postprandial distress (14 patients) and unexplained weight loss (3 patients).
• Mean aortamesenteric angle was 10.6 mm, mean aorta-SMA distance was 5.1 mm. No morbidity or mortality was observed. CONUT scores significantly improved postoperatively.

Conclusions:

• Laparoscopic duodenojejunostomy is a safe and effective surgical option for SMA syndrome.
• The procedure leads to significant improvement in patient recovery and nutritional status.
• This minimally invasive approach is recommended for patients who do not respond to conservative management.