Sakamoto T, Kubota T, Funakoshi H, Lefor AK. Multidisciplinary management of acute mesenteric ischemia: Surgery and endovascular intervention. World J Gastrointest Surg 2021; 13(8): 806-813 [PMID: 34512904 DOI: 10.4240/wjgs.v13.i8.806]
Corresponding Author of This Article
Takashi Sakamoto, MD, Attending Doctor, Senior Researcher, Surgeon, Surgical Oncologist, Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyō, Tokyo 1130033, Japan. sakamoto-kob@umin.ac.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2021; 13(8): 806-813 Published online Aug 27, 2021. doi: 10.4240/wjgs.v13.i8.806
Multidisciplinary management of acute mesenteric ischemia: Surgery and endovascular intervention
Takashi Sakamoto, Tadao Kubota, Hiraku Funakoshi, Alan Kawarai Lefor
Takashi Sakamoto, Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo 1130033, Japan
Takashi Sakamoto, Tadao Kubota, Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba 2790001, Japan
Hiraku Funakoshi, Department of Interventional Radiology, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba 2790001, Japan
Alan Kawarai Lefor, Department of Surgery, Jichi Medical University, Tochigi 3290498, Japan
Author contributions: Sakamoto T performed majority of the initial drafting and prepared the figure; Kubota T and Lefor A contributed to the conception and design of the study, and made critical revisions especially in the surgical aspects of the manuscript; Funakoshi H contributed to the conception and design of the study, and made critical revisions especially in the endovascular aspects of the manuscript; Lefor A made critical revisions especially in the surgical aspects of the manuscript and edited the manuscript as a native-English speaker.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Takashi Sakamoto, MD, Attending Doctor, Senior Researcher, Surgeon, Surgical Oncologist, Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyō, Tokyo 1130033, Japan. sakamoto-kob@umin.ac.jp
Received: February 12, 2021 Peer-review started: February 12, 2021 First decision: March 30, 2021 Revised: April 9, 2021 Accepted: July 7, 2021 Article in press: July 7, 2021 Published online: August 27, 2021 Processing time: 189 Days and 0.1 Hours
Abstract
Acute mesenteric ischemia (AMI) is a rare cause of the “acute abdomen”, characterized by impaired blood flow to the intestine. The principle of treatment is restoration of perfusion to ischemic bowel and resection of any necrotic intestine. Surgery and endovascular intervention are two complementary approaches to mesenteric ischemia. Endovascular intervention is not an alternative to the surgical approach, but it has the potential to improve the prognosis of patients with AMI when judiciously combined with a surgical approach. Due to the need for emergent treatment of patients with acute mesenteric ischemia, the treatment strategy needs to be modified for each facility. This review aims to highlight cutting-edge studies and provide reasonable treatment strategies for patients with acute mesenteric ischemia based on available evidence.
Core Tip: The management of acute mesenteric ischemia (AMI) is challenging. An increased number of endovascular interventions were performed in past decades. Endovascular interventions have the potential to improve the prognosis of patients with AMI when combined with a surgical approach. Due to the need for emergent treatment of patients with acute mesenteric ischemia, the treatment strategy needs to be modified for each facility. We discuss the treatment strategy for patients with AMI based on cutting-edge evidence.
