Asian Journal of Endoscopic Surgery最新文献

{"title":"A Case of Epidermal Cyst in the Retrorectum Safely Resected by a Combined Laparoscopic Approach","authors":"Yusuke Tanaka,&nbsp;Hiroaki Kasashima,&nbsp;Tatsunari Fukuoka,&nbsp;Ken Yonemitsu,&nbsp;Yuki Seki,&nbsp;Kenji Kuroda,&nbsp;Yuichiro Miki,&nbsp;Mami Yoshii,&nbsp;Tatsuro Tamura,&nbsp;Masatsune Shibutani,&nbsp;Takahiro Toyokawa,&nbsp;Shigeru Ree,&nbsp;Kiyoshi Maeda","doi":"10.1111/ases.70068","DOIUrl":"https://doi.org/10.1111/ases.70068","url":null,"abstract":"<p>The surgical indications and optimal approach for retrorectal tumors remain unclear due to their rarity and the anatomical complexity of the presacral space. We report the case of a 48-year-old man in whom a retrorectal mass was incidentally detected on abdominal and pelvic computed tomography. Magnetic resonance imaging demonstrated a cystic lesion measuring 32 × 12 × 20 mm, with low signal intensity on T1-weighted and high signal intensity on T2-weighted images. Given the difficulty of establishing a definitive diagnosis and the potential risk of infection or tumor seeding with biopsy, primary surgical resection was selected. A combined laparoscopic transabdominal and trans-sacral approach enabled precise dissection under enhanced visualization of the pelvic anatomy, ensuring safe and complete tumor excision. The patient's postoperative course was uneventful, and he remained recurrence-free at the 1-year follow-up. This case highlights the pivotal role of laparoscopy in facilitating the safe resection of retrorectal tumors.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Procedural Transhiatal Approach for the Thoracic Para-Aortic Lymph Node: A Case Report","authors":"Masashi Hashimoto,&nbsp;Kazuhiro Noma,&nbsp;Yasushige Takeda,&nbsp;Hijiri Matsumoto,&nbsp;Kento Kawasaki,&nbsp;Tomoyoshi Kunitomo,&nbsp;Naoaki Maeda,&nbsp;Shunsuke Tanabe,&nbsp;Toshiyoshi Fujiwara","doi":"10.1111/ases.70066","DOIUrl":"https://doi.org/10.1111/ases.70066","url":null,"abstract":"<p>The thoracic posterior para-aortic lymph node (TPAN) is classified as an extra-regional lymph node in esophageal cancer, with metastasis indicating poor prognosis. However, some cases with suspected TPAN metastasis may benefit from esophagectomy with lymph node dissection, including TPAN. This report presents the case of a 58-year-old man with upper thoracic esophageal squamous cell carcinoma and suspected simultaneous TPAN metastasis who underwent neoadjuvant chemotherapy followed by thoracoscopic subtotal esophagectomy and procedural transhiatal TPAN dissection. This transhiatal approach provided direct access to the lymph node without additional thoracic incisions, ensuring safe resection in coordination with the assistant and following anatomical landmarks systematically. Pathological examination showed a false-positive TPAN finding, though the patient later developed distant recurrence. Compared with conventional approaches, this transhiatal technique allows for procedural and reproducible lymphadenectomy while minimizing respiratory burden. This case highlights the feasibility of a transhiatal approach for TPAN dissection.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Infarction During Laparoscopic Ovarian Cystectomy in a Neonate: A Case Report","authors":"Naoki Hashizume,&nbsp;Saki Sakamoto,&nbsp;Masahiro Kinoshita,&nbsp;Daisuke Masui,&nbsp;Naruki Higashidate,&nbsp;Yoshinori Koga,&nbsp;Tatsuki Mizuochi,&nbsp;Tatsuru Kaji","doi":"10.1111/ases.70071","DOIUrl":"https://doi.org/10.1111/ases.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cerebral infarction following abdominal surgical procedures is a rare but serious complication in children. We report a rare case of a full-term neonate who developed a cerebral infarction after laparoscopic ovarian cystectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case</h3>\u0000 \u0000 <p>A neonate weighing 2350 g was prenatally diagnosed with a 30 mm complex ovarian cyst that was suspected to be torsional. At 3 days of age, she underwent laparoscopic ovarian cystectomy under general anesthesia. During the procedure, the twisted ovarian cyst, located in the upper abdomen, was excised after fluid drainage. The surgery lasted 64 min, with a pneumoperitoneum time of 33 min at a pressure of 8 mmHg. The surgery was uneventful. Hemodynamics were managed with fluid and albumin administration throughout the procedure. After pneumoperitoneum, blood pressure was decreased temporally, and ephedrine was administered, which led to recovery. However, at 12 h after surgery, cranial ultrasonography revealed a high-density area in the left basal ganglia, which was not detected in the head ultrasound preoperatively. This was later confirmed to be a cerebral infarction by magnetic resonance imaging (MRI). No cardiac or vascular malformations or hypercoagulability were observed. No additional treatment was administered for cerebral infarction. She was discharged 14 days after surgery. Follow-up MRI at 3 years post-surgery indicated chronic infarction. Fortunately, the patient exhibited no neurological abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the importance of identifying and mitigating the perioperative risks of cerebral infarction to improve the outcomes of laparoscopic surgery in neonates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metachronous Pancreatic Metastasis of Myxoid Liposarcoma Successfully Treated With Robotic Spleen-Preserving Distal Pancreatectomy With Splenic Vessels Resections: A Case Report","authors":"Yumi Sota,&nbsp;Kosei Takagi,&nbsp;Motohiko Yamada,&nbsp;Tomokazu Fuji,&nbsp;Kazuya Yasui,&nbsp;Takeyoshi Nishiyama,&nbsp;Yasuo Nagai,&nbsp;Noriyuki Kanehira,&nbsp;Akari Masunaga,&nbsp;Toshiyoshi Fujiwara","doi":"10.1111/ases.70069","DOIUrl":"https://doi.org/10.1111/ases.70069","url":null,"abstract":"<p>Pancreatic metastasis of myxoid liposarcoma (MLS) after primary resection is extremely rare. Herein, we present a case of metachronous pancreatic metastasis of MLS that was successfully treated with robotic spleen-preserving distal pancreatectomy (SPDP) using the Warshaw technique. A 60-year-old woman underwent radical resection of a 25-cm MLS in the right thigh after receiving neoadjuvant radiotherapy. The patient developed a 6-cm solitary pancreatic metastasis of the MLS 2 years later. Because no other distant metastases were detected, robotic SPDP (Warshaw technique) was performed. The operative time was 140 min with minimal blood loss. Follow-up at 3 months showed no recurrence. To our knowledge, this is the first report of a case of metachronous pancreatic metastasis of MLS successfully treated with robotic SPDP. Curative resection using minimally invasive surgery should be performed for solitary pancreatic metastases from MLS.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Laparoscopic and Thoracoscopic Biopsy via a Single Skin Incision Using a Port-Sharing Procedure in Infantile Neuroblastoma: A Case Report","authors":"Tokuro Baba,&nbsp;Satoru Hamada,&nbsp;Hideki Sakiyama,&nbsp;Shinobu Kiyuna,&nbsp;Tokiko Oshioro,&nbsp;Masaaki Kuda,&nbsp;Satoshi Ieiri,&nbsp;Mitsuhisa Takatsuki","doi":"10.1111/ases.70064","DOIUrl":"https://doi.org/10.1111/ases.70064","url":null,"abstract":"<p>Neuroblastoma, typically presenting with atypical symptoms, rarely manifests as a urachal tumor. We report a case of urachal neuroblastoma wherein a single port site was used for both laparotomy and thoracoscopy. A 1-month-old female presented with umbilical discharge. Enhanced computed tomography revealed a urachal tumor, later confirmed pathologically as neuroblastoma without MYCN amplification. During chemotherapy for low-risk classification, a right adrenal mass and mediastinal lymphadenopathy emerged, prompting further biopsy. We employed a port-sharing procedure at the right hypochondrium to perform simultaneous laparoscopic and thoracoscopic biopsies, reducing the number of port-side wounds. This approach could be applicable in other cases requiring combined thoracic and abdominal surgical access.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Time Identification of Lymph Vessels Using Indocyanine Green in a Patient With Chylothorax Associated With Lymphangioleiomyomatosis","authors":"Shinichi Sakamoto,&nbsp;Hiroaki Toba,&nbsp;Ayaka Baba,&nbsp;Emi Takehara,&nbsp;Keisuke Fujimoto,&nbsp;Taihei Takeuchi,&nbsp;Hiroyuki Sumitomo,&nbsp;Naoki Miyamoto,&nbsp;Atsushi Morishita,&nbsp;Naoya Kawakita,&nbsp;Hiromitsu Takizawa","doi":"10.1111/ases.70067","DOIUrl":"https://doi.org/10.1111/ases.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Lymphangioleiomyomatosis (LAM) is often complicated by chylothorax and may require surgical intervention; however, the treatment is complicated because of difficulties in identifying the location of the fistula intraoperatively. This is the first report to identify the site of a chyle fistula associated with LAM in real time during surgery by using indocyanine green (ICG) lymphangiography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>A 56-year-old woman received a diagnosis of a treatment-resistant left chylothorax associated with LAM. To identify the chyle fistula during surgery, 1 mL of ICG (2.5 mg) was injected into both inguinal lymph nodes under ultrasound guidance after anesthesia, with 1 mL per side for a total of 5 mg of ICG. We performed video-assisted thoracic surgery and observed near-infrared light acquisition and overlay technology using Stryker. Approximately 1 h after administration, fluorescence was observed in the anterior mediastinal lymph nodes, and a chyle fistula was observed around them. Although we attempted ligation of the lymph trunk, the surgical procedure damaged well-developed lymph vessels. The damaged area and anterior mediastinal lymph nodes, including the surrounding lymph vessels, were incinerated using soft coagulation and covered with polyglycolic acid sheets and fibrin glue. Consequently, the amount of chylous effusion decreased.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The use of ICG allowed visualization of the lymphatic pathway and location of the chyle fistula in real time during surgery, enabling precise local treatment to reduce chyle effusion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcomes of Robotic Adrenalectomy Compared to Laparoscopic Adrenalectomy: A Propensity Score Matching Study","authors":"Miki Naito,&nbsp;Hiroyuki Shikuma,&nbsp;Tomoya Hatayama,&nbsp;Kazuma Yukihiro,&nbsp;Kyosuke Iwane,&nbsp;Kenshiro Takemoto,&nbsp;Shunsuke Miyamoto,&nbsp;Kohei Kobatake,&nbsp;Yohei Sekino,&nbsp;Hiroyuki Kitano,&nbsp;Keisuke Goto,&nbsp;Akihiro Goriki,&nbsp;Keisuke Hieda,&nbsp;Nobuyuki Hinata","doi":"10.1111/ases.70062","DOIUrl":"https://doi.org/10.1111/ases.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Laparoscopic adrenalectomy is a common procedure for the treatment of adrenal tumors. However, the recent inclusion of robotic adrenalectomy in the list of insurance-covered procedures in Japan since April 2022 has raised questions regarding its broader clinical utility. This study aimed to elucidate the treatment outcomes of robotic adrenalectomy and conduct a comprehensive analysis comparing laparoscopic and robotic adrenalectomies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The baseline characteristics of patients and perioperative outcomes between laparoscopic and robotic adrenalectomies performed at Hiroshima University in July 2022 using the da Vinci Si, da Vinci Xi, and Hinotori were compared. Propensity score matching was performed to compare the outcomes of laparoscopic and robotic adrenalectomies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Laparoscopic and robotic adrenalectomies were performed in 292 and 43 patients, respectively. There were no statistically significant differences between equipment. In the baseline characteristics of patients, the body mass index of the laparoscopic adrenalectomy group was smaller than that of the robotic adrenalectomy group. As for perioperative outcomes, the length of stay and number of complications were less for robotic adrenalectomy than for laparoscopic adrenalectomy. After matching for the body mass index, robotic adrenalectomy showed less bleeding and fewer intraoperative complications than laparoscopic adrenalectomy. However, after matching for general factors, patients with robotic adrenalectomy had shorter hospital stays and fewer intraoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with laparoscopic adrenalectomy, robotic adrenalectomy can be performed safely with fewer intraoperative complications and may also have shorter hospital stays and minimal bleeding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous Onlay Laparoscopic Approach (SCOLA) for Swiss-Cheese Hernias Following Thoracoabdominal Incision: A Case Report","authors":"Amirah Lotfi Hanis,&nbsp;Sidi Nurazim,&nbsp;Sze Li Siow","doi":"10.1111/ases.70063","DOIUrl":"https://doi.org/10.1111/ases.70063","url":null,"abstract":"<div>\u0000 \u0000 <p>Swiss-cheese hernias, characterized by multiple small defects along a single incision, pose significant challenges after thoracoabdominal procedures. Although the Subcutaneous Onlay Laparoscopic Approach (SCOLA) is effective for midline ventral hernias and rectus abdominis diastasis, its role in non-midline incisional hernias remains underexplored. We present a 61-year-old male with multiple Swiss-cheese hernias along a thoracoabdominal incision following thoracic aortic aneurysm repair. CT revealed three defects: left subcostal (1.9 cm), left lumbar (1.5 cm), and left paramedian (0.3 cm). SCOLA was performed using pre-aponeurotic dissection, primary closure with non-absorbable barbed sutures, and reinforcement with overlapping polypropylene meshes. The patient recovered uneventfully, was discharged on postoperative day three, and remained free of recurrence or chronic pain at 8 months. This case highlights SCOLA's feasibility for complex non-midline incisional hernias, offering a minimally invasive approach that reduces mesh-related complications and postoperative pain, particularly in subcostal defects.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reevaluating the Therapeutic Role of Pelvic Lymph Node Dissection in Robot-Assisted Radical Prostatectomy","authors":"Ryosuke Yamase,&nbsp;Satoshi Yamamoto,&nbsp;Koki Watanabe,&nbsp;Atsushi Inoue,&nbsp;Kazuyoshi Nakamura,&nbsp;Maki Nagata","doi":"10.1111/ases.70061","DOIUrl":"https://doi.org/10.1111/ases.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Extended pelvic lymph node dissection (PLND) is recommended for intermediate- and high-risk prostate cancer according to D'Amico risk classification, and there is evidence supporting its diagnostic value in staging. However, its therapeutic benefit remains unproven. We, therefore, aimed to evaluate the therapeutic significance of PLND in patients undergoing robot-assisted radical prostatectomy (RARP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 329 patients with intermediate- or high-risk prostate cancer (per D'Amico risk classification) who underwent RARP at two centers. Patients were divided into two groups: those who did not undergo lymph node dissection (no-PLND group) and those who underwent an extended PLND (extended-PLND group). After excluding patients who received neoadjuvant hormone therapy, 313 cases remained for analysis. Propensity score matching was performed to balance baseline characteristics, yielding 85 matched pairs. We compared prostate-specific antigen progression-free survival (PSA-PFS) and overall survival (OS) between the matched groups. Perioperative outcomes (complications, console time, and blood loss) were also compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Kaplan–Meier analysis showed no significant differences in PSA-PFS (<i>p</i> = 0.163) or OS (<i>p</i> = 0.323) between the extended-PLND and no-PLND groups after matching. Similarly, when stratified by risk category, PSA-PFS did not differ significantly between the two groups for either intermediate-risk or high-risk patients. Perioperative blood loss was similar between groups, but the no-PLND group had a significantly lower overall complication rate (5.1% vs. 30.4%, <i>p</i> &lt; 0.001) and shorter median console time (160.2 vs. 230.5 min, <i>p</i> &lt; 0.001) than the extended-PLND group. Notably, no Grade 3–4 complications (Clavien–Dindo) occurred in the no-PLND group, compared to 11 cases in the extended-PLND group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In intermediate- and high-risk prostate cancer, performing an extended PLND during RARP did not improve biochemical recurrence-free or OS, suggesting minimal therapeutic benefit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Laparoscopic Surgery for Pancreaticoduodenal Artery Aneurysm Caused by Median Arcuate Ligament Syndrome","authors":"Fumitaka Nakayama,&nbsp;Koji Osumi,&nbsp;Shodai Mizuno,&nbsp;Takashi Takenoya,&nbsp;Ippei Oto,&nbsp;Tetsuya Nakamura,&nbsp;Katsunori Tanaka,&nbsp;Kazuhito Nagasaki,&nbsp;Noriaki Kameyama","doi":"10.1111/ases.70060","DOIUrl":"https://doi.org/10.1111/ases.70060","url":null,"abstract":"<div>\u0000 \u0000 <p>Pancreaticoduodenal artery (PDA) aneurysms are rare visceral aneurysms often associated with median arcuate ligament syndrome (MALS) due to compensatory high blood flow. Although endovascular treatment is the preferred approach, challenges such as contrast agent allergies and proximity to the superior mesenteric artery (SMA) may render such treatment unsuitable. Herein, we present a case of a 50-year-old female with a PDA aneurysm caused by MALS. Endovascular treatment was contraindicated because of contrast allergies and anatomical considerations. Laparoscopic surgery was performed to resect both the PDA aneurysm and the median arcuate ligament (MAL), marking the first reported case to use this approach. The procedure was successful, with no complications, and the patient was discharged on the fourth postoperative day. This case highlights the potential of laparoscopic surgery as a minimally invasive alternative for managing PDA aneurysms in complex clinical scenarios.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}