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Mesenteric artery surgery

Anthony H Chau, Haidar Abdul-Muhsin, Xin Peng, Victor J Davila, Erik P Castle, Samuel R Money
Renal nutcracker syndrome is an anatomic anomaly characterized by the compression of the left renal vein between the superior mesenteric artery and the aorta or between the aorta and the vertebral body. Diagnosis is often challenging. Common presenting symptoms include hematuria, abdominal pain, and pelvic congestion. Several open and endovascular techniques have been described to treat this syndrome. We report a novel surgical technique with robotic-assisted left renal vein transposition to treat a 19-year-old woman with renal nutcracker syndrome...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Qi Liu, Tian-Jia Li, Rong Zeng, Yue-Xin Chen, Wei Ye, Bao Liu, Chang-Wei Liu
Objective To investigate the optimal treatment strategy of spontaneous isolated dissection of superior mesenteric artery (SIDSMA) and the effect of anticoagulation therapy on the prognosis of SIDSMA. Methods The clinical data of 29 patients presented with acute or subacute mesenteric ischemia (a history of less than 14 days) due to SIDSMA admitted to the Department of Vascular Surgery of Peking Union Medical College Hospital from January 1st 2003 to December 31th 2016 were retrospectively analyzed. Results In this study,28 cases were male and the remaining one was female,with an average age of (49...
February 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Ruxandra Irina Negoi, Yosuke Inoue
The surgeon dissecting the base of the mesenterium, around the superior mesenteric vein (SMV) and artery, is facing a complex tridimensional vascular anatomy and should be aware of the anatomical variants in this area. The aim of this systematic review is to propose a standardized terminology of the superior mesenteric vessels, with impact in colon and pancreatic resections. We conducted a systematic search in PubMed/MEDLINE and Google Scholar databases up to March 2017. Forty-five studies, involving a total of 6090 specimens were included in the present meta-analysis...
March 8, 2018: Scientific Reports
Yuki Yoshioka, Kazuo Yoshioka, Shizuo Ikeyama
BACKGROUND: Gastric hematoma is a rare disorder. Here we report a case of a large gastric intramural hematoma mimicking an impending rupture of a visceral artery aneurysm. CASE PRESENTATION: A 60-year-old Japanese woman complained of left flank pain. Computed tomography with intravenously administered contrast agent showed a solid mass of 5 × 5 × 8 centimeter in the left middle abdominal quadrant. On completion of computed tomography, the working diagnosis was an impending rupture of an aneurysm located in a branch of the superior mesenteric artery...
March 7, 2018: Journal of Medical Case Reports
Aoi Hayasaki, Shuji Isaji, Masashi Kishiwada, Takehiro Fujii, Yusuke Iizawa, Hiroyuki Kato, Akihiro Tanemura, Yasuhiro Murata, Yoshinori Azumi, Naohisa Kuriyama, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai
Background : The aim of this study was to validate a new definition of borderline resectable pancreatic ductal adenocarcinoma (PDAC) provided by the 2017 international consensus on the basis of three dimensions of anatomical (A), biological (B), and conditional (C) factors, using the data of the patients who had been registered for our institutional protocol of chemoradiotherapy followed by surgery (CRTS) for localized patients with PDAC. Methods : Among 307 consecutive patients pathologically diagnosed with localized PDAC who were enrolled in our CRTS protocol from February 2005 to December 2016, we selected 285 patients who could be re-evaluated after CRT...
March 5, 2018: Cancers
Yu-Chen Fan, Fei-Long Ning, Chun-Dong Zhang, Dong-Qiu Dai
BACKGROUND: The aim of this study was to conduct a meta-analysis comparing the oncological, intraoperative and safety outcomes in sigmoid and rectal cancer surgery with and without preservation of the left colic artery (LCA). METHOD: We searched Medline, Embase, China National Knowledge Infrastructure (CNKI), and PubMed databases for relevant articles published between 1962 and 2017. Randomized and non-randomized clinical trials were identified and included in the study...
March 1, 2018: International Journal of Surgery
Mesut Özgökçe, Veysel Atilla Ayyıldız, Hayri Oğul, Harun Arslan, Abdussamet Batur, Alpaslan Yavuz, Suat İnce, Deniz Yüce
BACKGROUND: There is an increasing trend for administration of invasive radiological interventions, laparoscopic surgery, and transplantation procedures in recent years, and determining the vascular variations prior to these procedures is crucially important. Celiacomesenteric trunk (CMT) is among these variations. This study aimed to retrospectively evaluate this rare anomaly by computed tomography (CT). MATERIALS AND METHODS: A total of 1000 CT angiography images were analyzed retrospectively, and the patients with mesenteric and celiac arteries arising from the abdominal aorta with a single root were identified...
March 3, 2018: Folia Morphologica (Warsz)
Jonas Stroeder, Hagen Bomberg, Stefan Wagenpfeil, Arno Buecker, Hans-Joachim Schaefers, Marcus Katoh, Heinrich Volker Groesdonk, Peter Minko
OBJECTIVES: To prospectively evaluate the relationship of established inflammatory markers and presepsin on nonocclusive mesenteric ischemia and to correlate presepsin levels to the occurrence and severity of nonocclusive mesenteric ischemia. DESIGN: Patients were prospectively enrolled and blood samples taken, followed by a retrospective evaluation of laboratory values and angiographic findings. The study was ethics committee approved. SETTINGS: Patients with clinical suspicion of nonocclusive mesenteric ischemia underwent catheter angiography of the superior mesenteric artery...
February 27, 2018: Critical Care Medicine
Sara Catarino Santos, Ana Rita Loureiro, Rosa Simão, Jorge Pereira, Luís Filipe Pinheiro, Carlos Casimiro
Wilkie's syndrome, or superior mesenteric artery syndrome (SMAS), is a rare clinical entity caused by compression of the third portion of the duodenum between the abdominal aorta and superior mesenteric artery, leading to duodenal obstruction and severe malnutrition. The authors report a case of a female patient with years of chronic intestinal obstruction with abdominal pain, vomits and weight loss. Contrast intestinal series showed dilation of stomach and duodenum. Abdominal computed tomography study revealed findings compatible with SMAS...
February 2018: Journal of Surgical Case Reports
Bojan V Stimec, Bjarte T Andersen, Stefan R Benz, Jean H D Fasel, Knut M Augestad, Dejan Ignjatovic
BACKGROUND: The middle colic artery (MCA) is of crucial importance in abdominal surgery, for laparoscopic or open right and transverse colectomies. Against this background, a high number of reports concerning anatomical variations of the MCA have been published intended to contribute to the improvement of operative techniques for the treatment of colon cancer. Despite this extensive literature, briefly reviewed in the present paper, a course of the MCA posterior to the superior mesenteric vein, called a retromesenteric trajectory, has been related to only once, to the best of our knowledge...
February 22, 2018: International Journal of Colorectal Disease
F Weber, H Dralle
Neuroendocrine tumors of the small intestines are a rare disease with an incidence of 1 per 100,000 of the population; however, they account for over 20% of all neuroendocrine tumors and are the most common malignancy of the small intestines. Diagnosis is often made at a late stage of the disease, as the clinical symptoms are unspecific. Approximately one third of all patients show hepatic metastases at the time of diagnosis. There is no correlation between tumor size and tumor stage. Even small tumors <10 mm harbor the risk for lymphatic and distant metastases so that the extent of surgery is not determined by the size of the primary tumor...
February 20, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Bruno Freitas, Yvonne Bausback, Johannes Schuster, Matthias Ulrich, Sven Bräunlich, Andrej Schmidt, Dierk Scheinert
INTRODUCTION: To report our preliminary experience with endovascular revascularization of patients with acute mesenteric ischemia (AMI), using thrombectomy devices. MATERIAL AND METHODS: A retrospective analysis of patients admitted to our hospital due to AMI and who were subjected to concomitant or exclusive endovascular treatment, from January 2011 to January 2016. Patients were admitted at the emergency department, underwent imaging investigation and were referred to the endovascular specialist...
February 15, 2018: Annals of Vascular Surgery
Duarte Rego, Paulo Almeida, Paulo Soares, Rui Almeida
INTRODUCTION: Celiac artery (CA) occlusions/stenosis are infrequently associated with liver ischemia due to its unique vascularization where portal vein provides about 75% of liver's perfusion. Collateral flow from gastroduodenal artery also provides, in most cases, enough blood supply to prevent ischemic hepatitis. In cases where these collateral pathways are compromised severe liver ischemia can occur. METHODS: We present a case of acute mesenteric ischemia following gastric surgery that was treated with a hybrid retrograde CA stenting...
February 15, 2018: Annals of Vascular Surgery
Yafan Yang, Guiying Wang, Jingli He, Jianfeng Zhang, Jinchuan Xi, Feifei Wang
BACKGROUND: Colorectal cancer surgery includes "high tie" and "low tie"of the inferior mesenteric artery(IMA). However, different ligation level is closely related to the blood supply of anastomosis, which may increase the leakage rate, and it is unclear which technique confers a lower anastomotic leakage rate(AL) and survival advantage. OBJECTIVE: To compare the effectiveness and impact of inferior mesenteric artery (IMA) high ligation versus IMA low ligation on anastomotic leakage, lymph nodes yield rates and 5-year survival...
February 9, 2018: International Journal of Surgery
Konstantinos Spanos, Tilo Kölbel, George Kouvelos, Nikolaos Tsilimparis, Sebastian E Debus, Athanasios D Giannoukas
INTRODUCTION: The repair of long-term complications of open abdominal aortic repair such as para-anastomotic aneurysm (PAA) and pseudoaneurysm (PSA) is very challenging. The aim of this study was to assess the outcomes of endovascular repair of PAA/PSA after previous open aortic surgery for aneurismal or occlusive disease. EVIDENCE ACQUISITION: A systematic review was undertaken; a search was performed (PRISMA) in MEDLINE, CENTRAL, Cochrane databases and key references of all studies of endovascular treatment of PAA/PSA after open aortic surgery...
February 8, 2018: Journal of Cardiovascular Surgery
Shuai Wang, Han Liu, Qi Wang, Zhihua Cheng, Siqiao Sun, Yang Zhang, Xiwei Sun, Zhongying Wang, Liqun Ren
BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been shown to be valuable prognostic markers for a variety of pathological conditions including solid tumors, sepsis and others. However, the prognostic values of the NLR and PLR in patients with acute mesenteric arterial embolism (AMAE) and acute mesenteric arterial thrombosis (AMAT) have not been elucidated. The aim of this study was to determine the predictive value of the NLR and PLR for poor prognosis in patients with AMAE and AMAT...
February 8, 2018: Annals of Vascular Surgery
Stephanie Carvalho Borges, Paulo Emílio Botura Ferreira, Luisa Mota da Silva, Maria Fernanda de Paula Werner, Juan Manuel Irache, Osvaldo Albuquerque Cavalcanti, Nilza Cristina Buttow
The gastrointestinal tract is extremely sensitive to ischemia and reperfusion (I/R). Studies have reported that resveratrol (RSV) is able to combat damage caused by intestinal I/R. Because of its effectiveness in increasing the permanence and bioavailability of resveratrol in the intestinal epithelium, we investigated whether the effect of resveratrol-loaded in poly(anhydride) nanoparticles reduce oxidative stress and promote myenteric neuroprotection in the ileum of rats subjected to I/R. Physicochemical evaluations were performed on nanoparticles...
February 7, 2018: Toxicology
Daniel Vázquez-Vicente, Bárbara Fernández Del Bas, José García Villayzán, Javier Plaza Arranz, Luis Chiva
STUDY OBJECTIVE: The objective was to review/learn a surgical technique not very well known by gynecologic oncologists. DESIGN: Level of evidence: III SETTING: Review of a surgical technique with emphasis on the paraaortic sentinel lymph nodes using indocyanine green. INTERVENTION: The film features the following steps to perform the procedure: 1. Creating a retroperitoneal window. 2. What to do if the peritoneum is torn. 3. Finding the psoas muscle, right ureter, and common iliac artery...
February 7, 2018: Journal of Minimally Invasive Gynecology
Yuan Fang, Xu Han, Lingxiao Liu, Wenhui Lou
BACKGROUND: To evaluate the diagnostic and treatment efficacy of digital subtraction angiography (DSA), transcatheter arterial embolization (TAE) in post-pancreatectomy hemorrhage (PPH). MATERIALS AND METHODS: This is a single-center retrospective cohort study. Clinicopathological data of 23 patients with PPH from August 2009 to November 2016 were collected. We observed (1) DSA procedures and hemorrhagic sites (2) TAE: successful rate and complications (3) Follow-up...
February 7, 2018: International Journal of Surgery
Takatsugu Matsumoto, Keiichi Kubota, Taku Aoki, Takayuki Shimizu, Shozo Mori, Masato Kato, Hirotaka Asato
BACKGROUND/AIMS: Because of the anatomical characteristics, pancreatic cancers (PC) can easily invade to visceral vessels such as celiac artery, superior mesenteric artery, common hepatic artery (CHA) and portal vein, which makes curative resection difficult. In this study, we report an R0 resection for locally advanced PC by total pancreatectomy, combined resection of CHA, and reconstruction of hepatic artery using autologous left inferior phrenic artery (IPA). METHODS: A 47-year-old woman with complaints of low back pain was referred to our department...
February 7, 2018: Digestive Surgery
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