Javier A Cienfuegos1,2, Mateo G Estevez1,2, Miguel Ruiz-Canela2,3, Fernando Pardo1,2, Alberto Diez-Caballero4, Isabel Vivas2,5, Jose Ignacio Bilbao2,5, Pablo Martí-Cruchaga1,2, Gabriel Zozaya1,2, Víctor Valentí1,2, José Luis Hernández-Lizoáin1,2, Fernando Rotellar6,7. 1. Department of General Surgery, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain. 2. Instituto de Investigación Sanitaria de Navarra (IdisNA), Pamplona, Spain. 3. Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain. 4. Quirúrgica Cirujanos Asociados, Centro Médico Teknon, Barcelona, Spain. 5. Department of Radiology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain. 6. Department of General Surgery, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain. frotellar@unav.es. 7. Instituto de Investigación Sanitaria de Navarra (IdisNA), Pamplona, Spain. frotellar@unav.es.
Abstract
BACKGROUND: Laparoscopic arcuate ligament release has been demonstrated a valid therapeutic option for arcuate ligament syndrome. Nevertheless, long-term follow-up and predictive factors have not been described for this treatment. METHODS: Clinical and surgical data and short- and long-term outcomes together with the impact of the degree of stenosis of the celiac trunk were analyzed in 13 consecutive patients who underwent laparoscopic arcuate ligament release between 2001 and 2013. RESULTS: Thirteen patients (12 F/1 M) underwent surgery. The median age was 32 years old, and their mean body mass index was 20.7 (range 14.7-25). The 13 patients presented with intense postprandial abdominal pain. Ten cases were associated with weight loss. The median duration of symptoms was 24 months (range 2-240). Three patients presented symptoms associated with superior mesenteric artery syndrome. Median operative time was 120 min (range 90-240), and there were no conversions to open surgery. Median hospital stay was 3 days (range 2-14). Over a median follow-up of 117 months (range 45-185), nine patients had excellent results although two required endovascular procedures at 70 and 24 months after surgery. Four patients (30.7%) experienced poor outcomes. When we analyzed the impact of the degree of occlusion of the celiac trunk, we observed that in patients with severe occlusion (> 70%), better results were obtained, with complete resolution of symptoms in 71% of cases. CONCLUSION: Laparoscopic arcuate ligament release constitutes an excellent treatment for arcuate ligament syndrome. The degree of occlusion of the celiac trunk may be a factor predictive of long-term outcomes.
BACKGROUND: Laparoscopic arcuate ligament release has been demonstrated a valid therapeutic option for arcuate ligament syndrome. Nevertheless, long-term follow-up and predictive factors have not been described for this treatment. METHODS: Clinical and surgical data and short- and long-term outcomes together with the impact of the degree of stenosis of the celiac trunk were analyzed in 13 consecutive patients who underwent laparoscopic arcuate ligament release between 2001 and 2013. RESULTS: Thirteen patients (12 F/1 M) underwent surgery. The median age was 32 years old, and their mean body mass index was 20.7 (range 14.7-25). The 13 patients presented with intense postprandial abdominal pain. Ten cases were associated with weight loss. The median duration of symptoms was 24 months (range 2-240). Three patients presented symptoms associated with superior mesenteric artery syndrome. Median operative time was 120 min (range 90-240), and there were no conversions to open surgery. Median hospital stay was 3 days (range 2-14). Over a median follow-up of 117 months (range 45-185), nine patients had excellent results although two required endovascular procedures at 70 and 24 months after surgery. Four patients (30.7%) experienced poor outcomes. When we analyzed the impact of the degree of occlusion of the celiac trunk, we observed that in patients with severe occlusion (> 70%), better results were obtained, with complete resolution of symptoms in 71% of cases. CONCLUSION: Laparoscopic arcuate ligament release constitutes an excellent treatment for arcuate ligament syndrome. The degree of occlusion of the celiac trunk may be a factor predictive of long-term outcomes.
Authors: Javier A Cienfuegos; Luis Hurtado-Pardo; Víctor Valentí; Manuel F Landecho; Isabel Vivas; Mateo G Estévez; Alberto Diez-Caballero; José Luis Hernández-Lizoáin; Fernando Rotellar Journal: World J Surg Date: 2020-06 Impact factor: 3.352
Authors: Simen Tveten Berge; Nathkai Safi; Asle W Medhus; Jon O Sundhagen; Jonny Hisdal; Syed S H Kazmi Journal: Vasc Health Risk Manag Date: 2020-08-10