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Median arcuate ligament (Dunbar) syndrome: Laparoscopic management and clinical outcomes of a single centre

BACKGROUND: Median arcuate ligament syndrome (MALS) is a condition characterised by chronic abdominal symptoms associated with median arcuate ligament (MAL) compression of the coeliac artery. AIM: In this observational study, we aimed to evaluate the outcomes of laparoscopic treatment in patients wi...

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Autores principales: Kafadar, Mehmet Tolga, Oguz, Abdullah, Aday, Ulas, Bilge, Hüseyin, Basol, Ömer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270033/
https://www.ncbi.nlm.nih.gov/pubmed/33885017
http://dx.doi.org/10.4103/jmas.JMAS_265_20
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author Kafadar, Mehmet Tolga
Oguz, Abdullah
Aday, Ulas
Bilge, Hüseyin
Basol, Ömer
author_facet Kafadar, Mehmet Tolga
Oguz, Abdullah
Aday, Ulas
Bilge, Hüseyin
Basol, Ömer
author_sort Kafadar, Mehmet Tolga
collection PubMed
description BACKGROUND: Median arcuate ligament syndrome (MALS) is a condition characterised by chronic abdominal symptoms associated with median arcuate ligament (MAL) compression of the coeliac artery. AIM: In this observational study, we aimed to evaluate the outcomes of laparoscopic treatment in patients with MALS. MATERIALS AND METHODS: The data of ten patients with MALS who were subjected to laparoscopic sectioning of the MAL were retrospectively reviewed. The following data were evaluated: age, gender, clinical and diagnostic test findings, American Society of Anaesthesiologists score, operative findings and complications and mortality, hospital stay duration and hospital readmission. The diagnosis of MALS was established by computed tomography (CT) angiography. RESULTS: Six (60%) of ten patients with MALS were female and four (40%) were male. The mean age was 42.4 ± 12.3. The main symptoms were epigastric pain (100%) and weight loss (60%). CT angiography showed high-grade stenosis of the anterior wall of the proximal coeliac trunk and post-stenotic dilation caused by extrinsic compression of the MAL. Surgical procedure was uneventful in all patients. Operating time was 155.5 min (120–200) and intra-operative blood loss was 150 ml (100–250). Length of stay was 3.1 day (2–9), with no mortality. The post-operative complications developed in two female patients. One of them developed ileus and the other patient developed pulmonary thromboembolism. At 6-month follow-up, all patients were asymptomatic. CONCLUSION: Laparoscopic decompression is an effective treatment for MALS and can provide symptomatic relief. This method may be the preferred modality of treatment in view of its lack of morbidity and good results.
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spelling pubmed-82700332021-07-27 Median arcuate ligament (Dunbar) syndrome: Laparoscopic management and clinical outcomes of a single centre Kafadar, Mehmet Tolga Oguz, Abdullah Aday, Ulas Bilge, Hüseyin Basol, Ömer J Minim Access Surg Original Article BACKGROUND: Median arcuate ligament syndrome (MALS) is a condition characterised by chronic abdominal symptoms associated with median arcuate ligament (MAL) compression of the coeliac artery. AIM: In this observational study, we aimed to evaluate the outcomes of laparoscopic treatment in patients with MALS. MATERIALS AND METHODS: The data of ten patients with MALS who were subjected to laparoscopic sectioning of the MAL were retrospectively reviewed. The following data were evaluated: age, gender, clinical and diagnostic test findings, American Society of Anaesthesiologists score, operative findings and complications and mortality, hospital stay duration and hospital readmission. The diagnosis of MALS was established by computed tomography (CT) angiography. RESULTS: Six (60%) of ten patients with MALS were female and four (40%) were male. The mean age was 42.4 ± 12.3. The main symptoms were epigastric pain (100%) and weight loss (60%). CT angiography showed high-grade stenosis of the anterior wall of the proximal coeliac trunk and post-stenotic dilation caused by extrinsic compression of the MAL. Surgical procedure was uneventful in all patients. Operating time was 155.5 min (120–200) and intra-operative blood loss was 150 ml (100–250). Length of stay was 3.1 day (2–9), with no mortality. The post-operative complications developed in two female patients. One of them developed ileus and the other patient developed pulmonary thromboembolism. At 6-month follow-up, all patients were asymptomatic. CONCLUSION: Laparoscopic decompression is an effective treatment for MALS and can provide symptomatic relief. This method may be the preferred modality of treatment in view of its lack of morbidity and good results. Wolters Kluwer - Medknow 2021 2021-03-16 /pmc/articles/PMC8270033/ /pubmed/33885017 http://dx.doi.org/10.4103/jmas.JMAS_265_20 Text en Copyright: © 2021 Journal of Minimal Access Surgery https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kafadar, Mehmet Tolga
Oguz, Abdullah
Aday, Ulas
Bilge, Hüseyin
Basol, Ömer
Median arcuate ligament (Dunbar) syndrome: Laparoscopic management and clinical outcomes of a single centre
title Median arcuate ligament (Dunbar) syndrome: Laparoscopic management and clinical outcomes of a single centre
title_full Median arcuate ligament (Dunbar) syndrome: Laparoscopic management and clinical outcomes of a single centre
title_fullStr Median arcuate ligament (Dunbar) syndrome: Laparoscopic management and clinical outcomes of a single centre
title_full_unstemmed Median arcuate ligament (Dunbar) syndrome: Laparoscopic management and clinical outcomes of a single centre
title_short Median arcuate ligament (Dunbar) syndrome: Laparoscopic management and clinical outcomes of a single centre
title_sort median arcuate ligament (dunbar) syndrome: laparoscopic management and clinical outcomes of a single centre
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270033/
https://www.ncbi.nlm.nih.gov/pubmed/33885017
http://dx.doi.org/10.4103/jmas.JMAS_265_20
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