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Mesenteric artery surgery

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https://www.readbyqxmd.com/read/28342263/surgical-pitfalls-of-jejunal-vein-anatomy-in-pancreaticoduodenectomy
#1
Yoshiya Ishikawa, Daisuke Ban, Satoshi Matsumura, Yusuke Mitsunori, Takanori Ochiai, Atsushi Kudo, Shinji Tanaka, Minoru Tanabe
BACKGROUND: Pancreaticoduodenectomy (PD) is the standard surgical procedure for treating pancreatic head cancers. Considerable knowledge of proximal jejunal and pancreatic vein anatomy is a prerequisite for performing PD surgery safely, yet there appear to be no detailed descriptions of first and second jejunal vein (J1V, J2V) anatomy available in the literature. STUDY DESIGN: Adults with hepatobiliary-pancreatic disease underwent multidetector-row computed tomography with intravenous contrast (n=155), and SYNAPSE 3D(®) (Fujifilm Medical, Tokyo, Japan) was used to generate 3D-CT images...
March 24, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28341504/the-management-of-superior-mesenteric-artery-aneurysm-experience-with-16-cases-in-a-single-center
#2
Li Zilun, Yin Henghui, Zhao Yang, Wang Mian, Chang Guangqi, Wang Shenming
INTRODUCTION: Superior mesenteric artery aneurysm (SMAA) represents a rare but potentially fatal condition. This study aimed to present the individual management protocol of SMAA in our center and to discuss a potential preliminary treatment algorithm. MATERIALS AND METHODS: SMAA patients treated in our center between January 2007 and December 2014 were retrospectively reviewed on January 2015. RESULTS: Sixteen patients with SMAA were identified, including 1 female and 15 males, with a mean age of 48...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28340834/hepatic-artery-reconstruction-with-autologous-inferior-mesenteric-artery-graft-in-living-donor-liver-transplant-recipients
#3
M Özbilgin, T Ünek, T Egeli, C Ağalar, S Ozkardesler, F Obuz, H Ellidokuz, S Karademir, I Astarcıoğlu
INTRODUCTION: In living donor liver transplantation (LDLT), hepatic arterial continuity is crucial to avoid biliary leakage, biliary stricture, cholangitis, and graft and patient loss. Sometimes there exist factors making anastomosis difficult or even impossible. In these cases, a vascular graft may be needed to bridge the two arteries for revascularization. METHOD: Medical records of 297 patients who underwent LDLT between June 2000 and July 2016 at the Hepatopancreatobiliary Surgery and Liver Transplantation Unit of Dokuz Eylul University Hospital were reviewed retrospectively...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28329256/is-the-thoracic-aorta-a-safe-site-for-the-proximal-anastomosis-for-bypassing-the-mesenteric-arteries-in-patients-with-chronic-mesenteric-ischaemia
#4
James Barr, John Kokotsakis, Konstantinos Velissarios, Thanos Athanasiou
A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was whether the thoracic aorta is a safe site for the proximal anastomosis when bypassing the mesenteric arteries in patients with chronic mesenteric ischaemia. Five articles reported the use of the thoracic aorta as the site of proximal anastomosis in 35 patients with chronic mesenteric ischaemia. All of these studies were retrospective case reports or case series. The ascending aorta was the site for the proximal anastomosis in 7 patients with the descending thoracic aorta being used in the other 28 patients...
February 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28323157/anatomic-variations-of-inferior-mesenteric-artery-and-left-colic-artery-evaluated-by-3-dimensional-ct-angiography-insights-into-rectal-cancer-surgery
#5
Jia Ke, Jiawei Cai, Xiaofeng Wen, Xianrui Wu, Zhen He, Yifeng Zou, Jianping Qiu, Xiaowen He, Xiaosheng He, Lei Lian, Xiaojian Wu, Zhiyang Zhou, Ping Lan
OBJECTIVE: To demonstrate the clinical applicability of 3-dimensional CT angiography (3D-CTA) in evaluating the anatomic variations of inferior mesenteric artery (IMA) and left colic artery (LCA), to help make pre-operative strategies of rectal cancer surgery. METHODS: 188 patients with abdominal and pelvic contrast-enhanced CT scan were retrospectively enrolled and 3D-CTA was reconstructed. The origin and branching patterns of IMA, tracking patterns of LCA, intersectional patterns among IMA, LCA and inferior mesenteric vein (IMV) were examined, and their associations with clinical features were analyzed...
March 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28316225/-the-clinical-impact-of-artery-first-approach-combined-with-vascular-resection-and-reconstruction-in-the-treatment-of-pancreatic-head-carcinoma
#6
J L Huang, W G Li, F Z Chen, Z J Su, F M Li, B Liu
Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28301853/chronic-mesenteric-ischemia-patient-outcomes-using-open-surgical-revascularization
#7
Markus U Wagenhäuser, Yvonne K Meyer-Janiszewski, Philip Dueppers, Joshua M Spin, Nikolaos Floros, Hubert Schelzig, Mansur Duran
BACKGROUND: Chronic mesenteric ischemia (CMI) is a rare disease. Open treatment (OT) remains a valuable treatment option. We analyzed patient outcomes after OT and investigated health-related quality of life (HRQoL). METHODS: Data were analyzed retrospectively. The investigation period was from January 1, 2001, to December 31, 2014. We investigated mortality and patency rates using Kaplan-Meier analysis. HRQoL was measured using a 36-item health survey. Various statistical methods were employed...
March 17, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28293809/a-mesenteric-traction-syndrome-affects-near-infrared-spectroscopy-evaluated-cerebral-oxygenation-because-skin-blood-flow-increases
#8
Niels D Olesen, Henrik Sørensen, Rikard Ambrus, Lars B Svendsen, Anton Lund, Niels H Secher
During abdominal surgery manipulation of internal organs may induce a "mesenteric traction syndrome" (MTS) including a triad of flushing, hypotension, and tachycardia that lasts for about 30 min. We evaluated whether MTS affects near-infrared spectroscopy (NIRS) assessed frontal lobe oxygenation (ScO2) by an increase in forehead skin blood flow (SkBF). The study intended to include 10 patients who developed MTS during pancreaticoduodenectomy and 22 patients were enrolled (age 61 ± 8 years; mean ± SD)...
March 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28281726/anastomotic-loop-between-common-hepatic-artery-and-gastroduodenal-artery-in-coexistence-with-an-aberrant-right-hepatic-artery
#9
Konstantinos Natsis, Maria Piagkou, Theodosis Stamatopoulos, Ioannis Spyridakis, Stylianos Apostolidis
Anatomical variations of the hepatic arteries are not uncommon. The anomalous hepatic arterial supply is of paramount importance in hepatobiliary, pancreatic or liver transplantation and in laparoscopic surgery. We describe an unusual case of a 66-year-old Greek male cadaver, where a rare anastomosis (in the form of an enlarged arterial loop, 4.84 mm in diameter) between the common hepatic artery (6.42 mm) and the gastroduodenal artery (GDA) (4.82 mm) coexisted with an aberrant right hepatic artery (ARHA) (6...
March 10, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28266590/predictive-factors-of-intestinal-necrosis-in-acute-mesenteric-ischemia-prospective-study-from-an-intestinal-stroke-center
#10
Alexandre Nuzzo, Leon Maggiori, Maxime Ronot, Aymeric Becq, Aurelie Plessier, Nathalie Gault, Francisca Joly, Yves Castier, Valerie Vilgrain, Catherine Paugam, Yves Panis, Yoram Bouhnik, Dominique Cazals-Hatem, Olivier Corcos
OBJECTIVES: To identify predictive factors for irreversible transmural intestinal necrosis (ITIN) in acute mesenteric ischemia (AMI) and establish a risk score for ITIN. METHODS: This single-center prospective cohort study was performed between 2009 and 2015 in patients with AMI. The primary outcome was the occurrence of ITIN, confirmed by specimen analysis in patients who underwent surgery. Patients who recovered from AMI with no need for intestinal resection were considered not to have ITIN...
March 7, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28259479/-management-of-mesenteric-ischemia-in-the-era-of-intestinal-stroke-centers-the-gut-and-lifesaving-strategy
#11
A Nuzzo, O Corcos
Mesenteric ischemia is a gut and life-threatening, medical and surgical, digestive and vascular emergency. Mesenteric ischemia is the result of an arterial or venous occlusion, a vasospasm secondary to low-flow states in intensive care patients, aortic clamping during vascular surgery or intestinal transplantation. Progression towards mesenteric infarction and its complications is unpredictable and correlates with high rates of mortality or a high risk of short bowel syndrome in case of survival. Thus, mesenteric ischemia should be diagnosed and treated at an early stage, when gut injury is still reversible...
March 1, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28255734/robot-assisted-laparoscopic-transperitoneal-infrarenal-lymphadenectomy-in-patients-with-locally-advanced-cervical-cancer-by-single-docking-do-we-need-a-backup-procedure
#12
Fatih Gucer, Selim Misirlioglu, Nuri Ceydeli, Cagatay Taskiran
To present our initial experience on the feasibility of robotic transperitoneal para-aortic lymphadenectomy up to left renal vein via single docking approach by high port insertion technique followed by left shoulder docking as a rescue backup procedure in surgically obstructed patients undergoing surgical staging because of locally advanced cervical cancer (LACC). Prospective observational preliminary study. Canadian Task Force classification II-3. Tertiary-care academic affiliated private hospital. Ten patients with LACC who underwent robotic transperitoneal infrarenal para-aortic lymphadenectomy between January 2012 and December 2014...
March 2, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28243813/systematic-review-the-impact-of-exercise-on-mesenteric-blood-flow-and-its-implication-for-preoperative-rehabilitation
#13
REVIEW
K A Knight, S J Moug, M A West
BACKGROUND: Exercise in the preoperative period, or prehabilitation, continues to evolve as an important tool in optimising patients awaiting major intra-abdominal surgery. It has been shown to reduce rates of post-operative morbidity and length of hospital stay. The mechanism by which this is achieved remains poorly understood. Adaptations in mesenteric flow in response to exercise may play a role in improving post-operative recovery by reducing rates of ileus and anastomotic leak. AIMS: To systematically review the existing literature to clarify the impact of exercise on mesenteric arterial blood flow using Doppler ultrasound...
February 27, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28228071/a-rat-model-of-ischemic-enteritis-pathogenic-importance-of-enterobacteria-inos-no-and-cox-2-pge2
#14
Koji Takeuchi, Yoshino Komatsu, Yuka Nakamori, Tohru Kotani
BACKGROUND: We introduced a rat model of ischemic enteritis and investigated the roles of enterobacteria, nitric oxide (NO), and prostaglandins (PGs) in its pathogenesis. METHODS: Male rats were used after 18 h of fasting. Ischemic enteritis was induced by partial ligation of the superior mesenteric artery (SMA). Under ether anesthesia, SMA was isolated, and a stenosis was made by placing a needle (23 guage) on the vessel and ligating both the vessel and needle, and then a needle was removed from the ligature...
February 20, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28223737/pancreaticoduodenectomy-secondary-stenting-of-the-celiac-trunk-after-inefficient-median-arcuate-ligament-release-and-reoperation-as-an-alternative-to-simultaneous-hepatic-artery-reconstruction
#15
Théophile Guilbaud, Jacques Ewald, Olivier Turrini, Jean Robert Delpero
In patients undergoing pancreaticoduodenectomy (PD), unrecognized hemodynamically significant celiac axis (CA) stenosis impairs hepatic arterial flow by suppressing the collateral pathways supplying arterial flow from the superior mesenteric artery and leads to serious hepatobiliary complications due to liver and biliary ischemia, with a high rate of mortality. CA stenosis is usually due to an extrinsic compression by a previously asymptomatic median arcuate ligament (MAL). MAL is diagnosed by computerized tomography in about 10% of the candidates for PD, but only half are found to be hemodynamically significant during the gastroduodenal artery clamping test with Doppler assessment, which is mandatory before any resection...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28220469/ascending-colon-cancer-with-synchronous-external-iliac-and-inguinal-lymph-node-metastases-but-without-regional-lymph-node-metastasis-a-case-report-and-brief-literature-review
#16
Yuki Kitano, Masafumi Kuramoto, Toshiro Masuda, Daisuke Kuroda, Kenichiro Yamamoto, Satoshi Ikeshima, Ken-Ichi Iyama, Shinya Shimada, Hideo Baba
Lymph node metastasis to the iliac or inguinal region of colon cancer is extremely rare. We experienced a case of ascending colon cancer with synchronous isolated right external iliac and inguinal lymph node metastases but without any regional lymph node metastasis. An 83-year-old woman was admitted to our hospital due to anemia. Colonoscopy and computed tomography revealed an ascending colon cancer and also right external iliac and inguinal lymph node swelling. Further examination by F-deoxyglucose positron emission tomography strongly suggested that these lymph nodes were metastatic...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28216343/treatment-strategy-based-on-the-natural-course-for-patients-with-spontaneous-isolated-superior-mesenteric-artery-dissection
#17
Seon-Hee Heo, Young-Wook Kim, Shin-Young Woo, Yang-Jin Park, Kwang-Bo Park, Duk-Kyung Kim
OBJECTIVE: The optimal treatment of spontaneous isolated superior mesenteric artery dissection (SISMAD) is still not known, and we sought to determine an optimal treatment strategy for patients with SISMAD based on its natural clinical course. METHODS: We retrospectively reviewed consecutive patients with SISMAD treated from 2001 through 2016. Diagnosis and angiographic type of SISMAD were determined with contrast-enhanced computed tomography (CT) scan, and the clinical features were obtained using a fixed form questionnaire...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28213788/three-different-approaches-to-the-inferior-mesenteric-artery-during-robotic-d3-lymphadenectomy-for-rectal-cancer
#18
Songphol Malakorn, Tarik Sammour, Brian Bednarski, Yi-Qian Nancy You, George J Chang
BACKGROUND: In rectal cancer surgery, proximal ligation of the inferior mesenteric artery (IMA) with radical lymphadenectomy is the accepted standard of care.1 Our purpose is to describe three different standardized technical approaches for the management of the IMA during D3 lymphadenectomy.2 METHODS: Operative videos of three robotic D3 lymphadenectomy procedures for rectal cancer were reviewed and annotated with schematic anatomical descriptions for clarification. RESULTS: There are three methods for the management of the IMA during D3 lymphadenectomy for rectal cancer...
February 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28210507/super-selective-mesenteric-embolization-provides-effective-control-of-lower-gi-bleeding
#19
Toan Pham, Bob Anh Tran, Kevin Ooi, Marcus Mykytowycz, Stephen McLaughlin, Matthew Croxford, Iain Skinner, Ian Faragher
Introduction. We aimed to assess the efficacy and safety of digital subtraction angiography (DSA) and super-selective mesenteric artery embolization (SMAE) in managing lower GI bleeding (LGIB). Method. A retrospective case series of patients with LGIB treated with SMAE in our health service. Patients with confirmed active LGIB, on either radionuclide scintigraphy (RS) or contrast-enhanced multidetector CT angiography (CE-MDCT), were referred for DSA +/- SMAE. Data collected included patient characteristics, screening modality, bleeding territory, embolization technique, technical and clinical success, short-term to medium-term complications, 30-day mortality, and progression to surgery related to procedural failure or complications...
2017: Radiology Research and Practice
https://www.readbyqxmd.com/read/28195969/acute-mesenteric-ischemia-among-postcardiac-surgery-patients-presenting-with-multiple-organ-failure
#20
Alexis Guillaume, Sébastien Pili-Floury, Sidney Chocron, Eric Delabrousse, Bénédicte De Parseval, Stephane Koch, Emmanuel Samain, Gilles Capellier, Gaël Piton
BACKGROUND: Acute mesenteric ischemia (AMI) is a rare but severe complication after cardiac surgery. However, AMI is likely to be more frequent in the subgroup of patients presenting with multiple organ failure after a cardiac surgery. The primary objective of this study was to identify AMI risk factors among patients requiring intensive care unit (ICU) admission after cardiac surgery. METHODS: Retrospective observational study of all the patients requiring admission to two ICUs in a large university hospital after a cardiac surgery procedure...
March 2017: Shock
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