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Mesenteric artery surgery

Wei Yu, Wei Hu, Yongjie Shui, Xiaoyang Zhu, Chao Li, Xiaoqiu Ren, Xueli Bai, Risheng Yu, Li Shen, Tingbo Liang, Lei Zheng, Qichun Wei
OBJECTIVES: To explore the areas at highest risk for postoperative pancreatic cancer local recurrence according to the spatial location of local failures, with the aim to provide a precise target volume for pancreatic cancer adjuvant radiotherapy. METHODS: Patients with pancreatic cancer who had undergone surgery for the primary tumor in pancreas at our institution from January 2010 to August 2015 were retrospectively analyzed. All local recurrences were plotted on the computed tomography (CT) image of a representative patient according to their relative coordinates to superior mesenteric artery (SMA) or celiac axis (CA)...
October 19, 2016: Radiation Oncology
F J Bohanon, O Nunez Lopez, B M Graham, L W Griffin, R S Radhakrishnan
Superior mesenteric artery syndrome (SMAS) is a rare, debilitating clinical condition caused by compression of the third portion of the duodenum by the superior mesenteric artery. Common symptoms include intermittent postprandial abdominal pain, nausea, weight loss, and bilious vomiting. Here we present a case series of three patients with SMAS who were treated with laparoscopic duodenojejunostomy. Patients were females between 12-17 years old. All patients underwent a successful laparoscopic duodenojejunostomy after diagnosis...
2016: Int J Surg Res
Martijn L Dijkstra, Peter C J M Goverde, Andrew Holden, Clark J Zeebregts, Michel M P J Reijnen
PURPOSE: To show feasibility of the covered endovascular repair of the aortic bifurcation (CERAB) technique in conjunction with chimney grafts in aortic side branches for complex aortoiliac occlusive disease. METHODS: Two European centers and one facility located in New Zealand participated in a retrospective observational study that enrolled 14 consecutive patients (mean age 61.2±8.9 years; 11 men) treated with CERAB in conjunction with chimney graft(s) between December 2012 and May 2015...
October 14, 2016: Journal of Endovascular Therapy
Ashok Kumar, Anshul Goel, Mehul Lapsiwala
Polyarteritis nodosa is a medium artery vasculitis that can cause fatal complications. It commonly follows an acute monophasic course that may remit after treatment or cause serious morbidity or death. A 24-year-old patient described here had many vasculitic episodes in the past 16 years causing infarction of different organs. The last episode was most serious which caused mononeuritis multiplex, digital gangrene, bowel gangrene and subsequent perforations. There was strong clinical suspicion of this disease right from the beginning...
October 2016: Oxford Medical Case Reports
Y Sun, P Chi, H Lin, X Lu, Y Huang, Z Xu, S Huang, X Wang
AIM: To assess the effect of neoadjuvant chemoradiotherapy (nCRT) on inferior mesenteric artery (IMA) nodal metastasis and identify predictors for IMA nodal metastasis in locally advanced rectal cancer (LARC) after nCRT. METHOD: Propensity score matching of 1167 patients with LARC was performed. Clinicopathological predictors and survival rates were analyzed using univariate and multivariate analyses. RESULTS: Compared to surgery alone, nCRT reduced the incidence of IMA nodal metastasis (before matching, 4...
September 24, 2016: European Journal of Surgical Oncology
Evelien P J G Neis, S Sabrkhany, I Hundscheid, D Schellekens, K Lenaerts, S W Olde Damink, E E Blaak, C H C Dejong, Sander S Rensen
Plasma levels of several amino acids are correlated with metabolic dysregulation in obesity and type 2 diabetes. To increase our understanding of human amino-acid metabolism, we aimed to determine splanchnic interorgan amino-acid handling. Twenty patients planned to undergo a pylorus preserving pancreatico-duodenectomy were included in this study. Blood was sampled from the portal vein, hepatic vein, superior mesenteric vein, inferior mesenteric vein, splenic vein, renal vein, and the radial artery during surgery...
October 6, 2016: Amino Acids
Jun Watanabe, Mitsuyoshi Ota, Yusuke Suwa, Atsushi Ishibe, Hidenobu Masui, Kaoru Nagahori
PURPOSE: The treatment of splenic flexural colon cancer is not standardized because the lymphatic drainage is variable. The aim of this study is to evaluate the lymph flow at the splenic flexure. METHODS: From July 2013 to January 2016, consecutive patients of the splenic flexural colon cancer with a preoperative diagnosis of N0 who underwent laparoscopic surgery were enrolled. Primary outcome is frequency of the direction of lymph flow from splenic flexure. We injected indocyanine green (2...
October 1, 2016: International Journal of Colorectal Disease
Frederick H Koh, Ker-Kan Tan
BACKGROUND: Anastomotic leakage after gastrointestinal surgery is associated with significant morbidity and mortality.1 Insufficient vascular supply is one cause.2 Recent reports of using intraoperative indocyanine green (ICG) fluorescent angiography to evaluate whether perfusion of the anastomosis is adequate has yielded positive outcomes.3 (-) 6 The authors describe their use of ICG-enhanced fluorescence angiography in a laparoscopic anterior resection. METHODS: The patient was an 80-year-old with an upper rectal adenocarcinoma and significant cardiovascular risk factors...
September 28, 2016: Annals of Surgical Oncology
Yuji Kanaoka, Takao Ohki, Hirotsugu Ozawa
We report a case in which a stent graft and an Amplatzer® vascular plug (AVP) were effective for the treatment of chronic aneurysmal aortic dissection. The patient was a 52-year-old man. At 45 years of age, he developed acute aortic dissection, for which he underwent surgery four times with prosthetic graft replacement in the abdominal aorta, descending thoracic, ascending aorta (without neck branch reconstruction), and thoracoabdominal aorta with the reconstruction of the celiac, superior mesenteric and bilateral renal arteries...
September 23, 2016: Annals of Vascular Surgery
Stephanie Carvalho Borges, Aline Cristine da Silva de Souza, Evandro José Beraldi, Larissa Carla Lauer Schneider, Nilza Cristina Buttow
AIMS: The present study evaluated the effects of resveratrol in the myenteric plexus after intestinal ischemia-reperfusion (I/R) injury caused by occluding the superior mesenteric artery for 45min, followed by 7days of reperfusion. MAIN METHODS: Forty-two male Wistar rats were divided into seven groups: control (C group), untreated sham surgery control (SC group), sham surgery control treated with resveratrol before surgery (STA group), sham surgery control treated with resveratrol before and after surgery (STAD group), ischemic control (IRC group), ischemic treated before I/R (IRTA group), and ischemic treated before and after I/R (IRTAD group)...
September 23, 2016: Life Sciences
Kyu Sung Choi, Young Hun Choi, Jung-Eun Cheon, Woo Sun Kim, In One Kim
PURPOSE: To assess the usefulness of the relative position of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in diagnosing intestinal malrotation in situs anomaly. MATERIALS AND METHODS: From January 2004 to April 2015, 33 patients with situs anomalies were enrolled in this study who underwent abdominal USG, CT or MRI as well as upper gastrointestinal series (UGIS) or surgery: situs inversus (n=16), left isomerism (n=10), and right isomerism (n=7); age 21...
October 2016: European Journal of Radiology
Fernando Korkes, Marcel Silveira, Oseas Castro Neves-Neto, Luiz Franco Brandão, Marcos Tobias-Machado, Nelson Wolosker, Felipe Nasser, Alexandre Maurano
Nutcracker syndrome refers to the complex of clinical symptoms caused by the compression of the left renal vein (LRV) between the abdominal aorta and the superior mesenteric artery, leading to stenosis of the aortomesenteric portion of the LRV and dilatation of the distal portion. Hematuria, proteinuria, flank pain, varicocele and pelvic congestion may occur, occurring more frequently in young adults. Conservative management, might be the option whenever it is possible. When surgical treatment is required, classically open surgery have been performed, with major surgeries as LRV transposition or bypass techniques...
September 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Yu-Hua Zhang, Cheng-Wu Zhang, Zhi-Ming Hu, De-Fei Hong
Pancreatic duct adenocarcinoma is one of the most fatal malignancies, with R0 resection remaining the most important part of treatment of this malignancy. However, pancreatectomy is believed to be one of the most challenging procedures and R0 resection remains the only chance for patients with pancreatic cancer to have a good prognosis. Some surgeons have tried minimally invasive pancreatic surgery, but the short- and long-term outcomes of pancreatic malignancy remain controversial between open and minimally invasive procedures...
August 28, 2016: World Journal of Gastroenterology: WJG
Yu Horiuchi, Mika Izumo, Takayoshi Kusuhara, Motoi Yokozuka, Takeshi Taketani, Kengo Tanabe
This report describes an elderly severe aortic stenosis (AS) patient, who had a history of coronary artery bypass grafting and endovascular repair for an abdominal aortic aneurysm (AAA). Type II endoleak with enlargement of AAA was diagnosed and ligation of inferior mesenteric artery (IMA) was recommended. Because aortic valve replacement (AVR) was high risk, we planned transcatheter aortic valve implantation (TAVI). Considering risks of IMA ligation under dual antiplatelet therapy, increased blood pressure after TAVI, and general anesthesia, we performed combined TAVI and IMA ligation...
September 7, 2016: Cardiovascular Intervention and Therapeutics
Jiqiao Zhu, Dongdong Han, Xianliang Li, Fei Pan, Jun Ma, Jiantao Kou, Hua Fan, Ren Lang, Qiang He
BACKGROUND: Early diagnosis of superior mesenteric artery (SMA) involvement is vital for patients with a borderline resectable cancer of the pancreatic head to achieve an R0 resection. We aimed to detect the effect of the inferior infracolic 'superior mesenteric artery first' approach with a no-touch isolation surgical technique in these patients. METHODS: The data of 21 patients who were consecutively diagnosed with a borderline resectable cancer of the pancreatic head and treated with our technique between July 2014 and September 2015 were analyzed...
September 6, 2016: Annals of Surgical Oncology
Xiaoliang Shu, Jian Zhang, Qingxiu Wang, Zengguang Xu, Tingting Yu
Intestinal ischemia-reperfusion (IR) is a common clinical pathophysiological process that is common in severe trauma, major surgery, and in post-resuscitation. Glutamine (Gln) reduces intestinal IR injury, however, its mechanism of action remains to be determined. High mobility group box 1 (HMGB1) protein, nuclear factor-κB (NF-κB), tumor necrosis factor-α (TNF-α), and interleukin-1 (IL-1) are mediators involved in the pathophysiology of intestinal IR injury. The aim of the present study was to investigate the effects of Gln on the intestinal mucosa of HMGB1 expression following IR to determine whether Gln relieved intestinal IR injury in the intestinal mucosal barrier...
September 2016: Experimental and Therapeutic Medicine
Toshihisa Ichiba, Masahiko Hara, Keiji Yunoki, Masaki Urashima, Masao Harano, Hiroshi Naitou, Kouji Yamamoto, Ayumi Shintani
OBJECTIVE: Acute mesenteric ischemia (AMI) is a potentially fatal vascular emergency, and several computed tomographic (CT) findings have been introduced to determine the presence of intestinal ischemia or necrosis, although the most useful finding is unknown. METHODS: We retrospectively analyzed data of 43 consecutive patients with AMI who were treated during the period from 2006 to 2015. Study patients included both superior mesenteric artery dissection (n = 29) and thrombosis (SMAT, n = 14)...
August 12, 2016: American Journal of Emergency Medicine
Sofia Westermark, Elena Rangelova, Christoph Ansorge, Lars Lundell, Ralf Segersvärd, Marco Del Chiaro
BACKGROUND: The recent development of new neo-adjuvant treatment regimens associated with a higher success rate of down-staging has increased the interest of pancreatic surgeons on the role of extended surgery for patients affected by locally advanced pancreatic cancer. Pancreatectomy together with resection of the portal/superior mesenteric vein is considered nowadays standard of care for patients affected by pancreatic cancer. However, the resection of major abdominal arteries is still debatable...
August 25, 2016: Langenbeck's Archives of Surgery
Frederick H Koh, Ker-Kan Tan
BACKGROUND: Laparoscopic extended right hemicolectomy is regarded as one of the more difficult procedures in colorectal surgery due to the complexity of the dissection around the pancreatic neck to identify the origin of the middle colic artery.1 Proper identification and ligation of the middle colic artery at its origin is paramount to achieve complete mesocolic excision.2 (,) 3 We describe our technique of middle colic vessels dissection in a laparoscopic extended right hemicolectomy...
August 22, 2016: Annals of Surgical Oncology
Oktay Karakose, Mehmet Fatih Benzin, Huseyin Pülat, Mehmet Zafer Sabuncuoglu, Huseyin Eken, Ismail Zihni, Ibrahim Barut
BACKGROUND Planned re-laparotomies are a series of surgical interventions that are rarely used and have a high mortality rate. The aim of this study was to investigate the factors affecting mortality and the effectiveness of the use of the Bogota bag for temporary closure of the abdomen in patients for whom re-laparotomy was planned. MATERIAL AND METHODS A retrospective examination was made of data of patients in whom a Bogota bag was used in planned re-laparotomies for various reasons in the General Surgery Department of Suleyman Demirel University Medical Faculty between June 2008 and April 2014...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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