Published online Feb 27, 2023. doi: 10.4240/wjgs.v15.i2.193
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
Processing time: 187 Days and 23.8 Hours
Superior mesenteric artery syndrome after laparoscopic-assisted radical right hemicolectomy is a rare complication and can often be unrecognized by radiologists and clinicians.
Help people understand postoperative superior mesenteric artery syndrome.
Potential risk factors for the development of superior mesenteric artery syndrome were analyzed through case discussions and review of the literature.
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.
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.
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.
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.