Application of laparoscopic duodenojejunostomy for children with superior mesenteric artery syndrome

Q4 Medicine
Xinke Qin, X. Duan, Zhen Qin, H. Bian, Chong Liang
{"title":"Application of laparoscopic duodenojejunostomy for children with superior mesenteric artery syndrome","authors":"Xinke Qin, X. Duan, Zhen Qin, H. Bian, Chong Liang","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.01.011","DOIUrl":null,"url":null,"abstract":"Objective \nTo evaluate the efficacy of laparoscopic duodenojejunostomy for superior mesenteric artery syndrome (SMAS) in children. \n \n \nMethods \nBetween 2015 to 2018, 4 SMAS children underwent laparoscopic duodenojejunostomy after a failure of conservative measures. For evaluating surgical efficacies, their clinical data and postoperative complications were recorded and analyzed. \n \n \nResults \nThere were 1 boy and 3 girls. All of them were emaciated and slender. There was a sudden postprandial onset of bilious vomiting and abdominal pain. The average duration of illness was 1 month. Disturbances of water and electrolyte and malnutrition were quite common. However, symptomatic relief in knee-chest posture and wave of reverse peristalsis were not obvious. Their average weight at admission was 22.5 kg and body mass index (BMI) 14.2 kg/m2. Upper gastrointestinal radiography revealed obstruction of the third part of duodenum. And abdominal CT indicated an aortomesenteric angle of 13° and an aortomensenteric distance of 7 mm with gastric and proximal duodenal dilatation. If conservative measures failed, laparoscopic duodenojejunostomy was performed. The average operation time was 150 min. There were no postoperative complications such as obstruction, anastomotic leakage or anastomotic stenosis. Vomiting and abdominal pain were relieved. A month later, there was an average weight gain of 5.25 kg and BMI increased to 17.6 kg/m2. \n \n \nConclusions \nLaparoscopic duodenojejunostomy is both simple and efficacious for SMAS with fewer postoperative complications and a lower recurrence rate in children. During operation, anastomosis should be large enough to avoid stenosis and anastomotic site should be close to obstruction site for reducing the length of non-functional bowel and lowering the incidence of blind loop syndrome. \n \n \nKey words: \nChild; Superior mesenteric artery syndrome; Laparoscopic duodenojejunostomy","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"41 1","pages":"52-55"},"PeriodicalIF":0.0000,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华小儿外科杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.01.011","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

Abstract

Objective To evaluate the efficacy of laparoscopic duodenojejunostomy for superior mesenteric artery syndrome (SMAS) in children. Methods Between 2015 to 2018, 4 SMAS children underwent laparoscopic duodenojejunostomy after a failure of conservative measures. For evaluating surgical efficacies, their clinical data and postoperative complications were recorded and analyzed. Results There were 1 boy and 3 girls. All of them were emaciated and slender. There was a sudden postprandial onset of bilious vomiting and abdominal pain. The average duration of illness was 1 month. Disturbances of water and electrolyte and malnutrition were quite common. However, symptomatic relief in knee-chest posture and wave of reverse peristalsis were not obvious. Their average weight at admission was 22.5 kg and body mass index (BMI) 14.2 kg/m2. Upper gastrointestinal radiography revealed obstruction of the third part of duodenum. And abdominal CT indicated an aortomesenteric angle of 13° and an aortomensenteric distance of 7 mm with gastric and proximal duodenal dilatation. If conservative measures failed, laparoscopic duodenojejunostomy was performed. The average operation time was 150 min. There were no postoperative complications such as obstruction, anastomotic leakage or anastomotic stenosis. Vomiting and abdominal pain were relieved. A month later, there was an average weight gain of 5.25 kg and BMI increased to 17.6 kg/m2. Conclusions Laparoscopic duodenojejunostomy is both simple and efficacious for SMAS with fewer postoperative complications and a lower recurrence rate in children. During operation, anastomosis should be large enough to avoid stenosis and anastomotic site should be close to obstruction site for reducing the length of non-functional bowel and lowering the incidence of blind loop syndrome. Key words: Child; Superior mesenteric artery syndrome; Laparoscopic duodenojejunostomy
腹腔镜十二指肠空肠吻合术在儿童肠系膜上动脉综合征中的应用
目的探讨腹腔镜十二指肠空肠吻合术治疗儿童肠系膜上动脉综合征(SMAS)的疗效。方法2015年至2018年,4例SMAS患儿在保守措施失败后行腹腔镜十二指肠空肠造口术。为评价手术效果,记录并分析患者的临床资料及术后并发症。结果男1例,女3例。他们都瘦弱而纤细。餐后突然出现胆汁性呕吐和腹痛。平均病程1个月。水电解质紊乱和营养不良相当常见。而膝胸体位和逆肠波的症状缓解不明显。入院时平均体重22.5 kg,体重指数(BMI) 14.2 kg/m2。上胃肠造影显示十二指肠第三段梗阻。腹部CT示主动脉肠系膜角13°,主动脉肠系膜距离7 mm,胃及近端十二指肠扩张。如果保守措施失败,则行腹腔镜十二指肠空肠吻合术。平均手术时间150 min,术后无梗阻、吻合口瘘、吻合口狭窄等并发症。呕吐和腹痛得到缓解。一个月后,平均体重增加5.25 kg, BMI增加到17.6 kg/m2。结论腹腔镜十二指肠空肠吻合术治疗儿童小肠胃炎简便有效,术后并发症少,复发率低。术中吻合口应足够大,避免狭窄,吻合口应靠近梗阻部位,以减少无功能肠的长度,降低盲袢综合征的发生率。关键词:儿童;肠系膜上动脉综合征;腹腔镜duodenojejunostomy
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
中华小儿外科杂志
中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health
CiteScore
0.40
自引率
0.00%
发文量
8707
期刊介绍: Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信