Xie J, Bai J, Zheng T, Shu J, Liu ML. Causes of epigastric pain and vomiting after laparoscopic-assisted radical right hemicolectomy - superior mesenteric artery syndrome. World J Gastrointest Surg 2023; 15(2): 193-200 [PMID: 36896299 DOI: 10.4240/wjgs.v15.i2.193]
Corresponding Author of This Article
Juan Xie, Department of Radiology, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou 646000, Sichuan Province, China. 408588766@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
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. Feb 27, 2023; 15(2): 193-200 Published online Feb 27, 2023. doi: 10.4240/wjgs.v15.i2.193
Causes of epigastric pain and vomiting after laparoscopic-assisted radical right hemicolectomy - superior mesenteric artery syndrome
Juan Xie, Jiao Bai, Ting Zheng, Jian Shu, Ma-Li Liu
Juan Xie, Jiao Bai, Ting Zheng, Jian Shu, Ma-Li Liu, Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: Xie J, Bai J, Zheng T, Shu J, and Liu ML designed and performed the research; Xie J analyzed the data and wrote the manuscript.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Affiliated Hospital of Southwest Medical University (Approval No. KY2022233).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Juan Xie, Department of Radiology, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou 646000, Sichuan Province, China. 408588766@qq.com
Received: August 23, 2022 Peer-review started: August 23, 2022 First decision: November 5, 2022 Revised: November 19, 2022 Accepted: January 9, 2023 Article in press: January 9, 2023 Published online: February 27, 2023
ARTICLE HIGHLIGHTS
Research background
Superior mesenteric artery syndrome after laparoscopic-assisted radical right hemicolectomy is a rare complication and can often be unrecognized by radiologists and clinicians.
Research motivation
Help people understand postoperative superior mesenteric artery syndrome.
Research objectives
Potential risk factors for the development of superior mesenteric artery syndrome were analyzed through case discussions and review of the literature.
Research methods
The preoperative and postoperative aortomesenteric angle and distance were compared in the experimental group of 6 patients, and 20 patients without postoperative SMAS in the 256 patients were randomly selected for comparative analysis with 6 patients developed SMAS.
Research results
In the experimental group, the aortomesenteric angle and distance after surgery were significantly decreased than those before surgery. The aortomesenteric angle, distance and BMI were significantly higher in the control group than in the experimental. There was no significant difference in the type of lymphadenectomy and surgical approach between the two groups.
Research conclusions
The small preoperative aortomesenteric angle and distance and low BMI may be important factors for the complication. Over-cleaning of lymph fatty tissues may also be associated with this complication.
Research perspectives
Future studies should explore whether the occurrence of obstruction can be reduced in patients prone to SMAS after right hemicolectomy by improving reconstruction of the anastomotic colonic segment to reduce its pull on the superior mesenteric vessels or by prophylactic release of the ligament of Treitz.
