Xinke Qin, X. Duan, Zhen Qin, H. Bian, Chong Liang
{"title":"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","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":"{\"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}","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}
Application of laparoscopic duodenojejunostomy for children with superior mesenteric artery syndrome
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
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.