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Surgical Intervention Could Relieve Obstruction-Related Symptoms of Refractory Superior Mesenteric Artery Syndrome: Long-Term Follow-up Results

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Abstract

Purpose

Superior mesenteric artery syndrome (SMAS) is one of the rare causes of chronic duodenal obstruction. The aim of our study was to evaluate the outcomes of surgical management of refractory SMAS (Re-SMAS) in our institution during the last decade.

Materials and Methods

Consecutive patients diagnosed as Re-SMAS and underwent surgical intervention were retrospectively enrolled. A modified Likert-scale-based questionnaire was used to quantify the symptoms of SMAS. The primary outcome was the increase of BMI and symptomatic relief after surgery.

Results

From January 2010 to January 2020, 22 patients diagnosed with Re-SMAS and underwent surgery were included. Age distribution of included patients were < 19 (10/22, 45%), 19–45 (11/22, 50%), and > 45 (1/22, 5%). A significant BMI increase was recorded, [16.1 (14.6–23.7) kg/m2 vs 21.9 (15.6–29.5) kg/m2 before and after surgery, respectively, p < 0.001]. Up to 20 patients (20/22, 91%) reported symptomatic relief. The obstruction-related symptom score decreasing significantly (p < 0.001), with reported nausea, vomiting, and regurgitation incidences dropping from 77 to 41% (p = 0.031), 68 to 23% (p = 0.006), and 32 to 5% (p = 0.046), respectively.

Conclusion

Surgical interventions could relieve obstruction-related symptoms of Re-SMAS and promote weight gain. For patients who suffered from Re-SMAS and referred to surgeons mainly for obstruction-related symptoms, surgical intervention is recommended.

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Data Availability

The data that support the findings of this study are not publicly available due to their containing information that could compromise the privacy of research participants but are available from the corresponding author (ZQ. W) upon reasonable request.

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Funding

The work is supported by Department of Science and Technology of Sichuan Province (No. 2018RZ0091) and West China Hospital of Sichuan University (1·3·5 project of disciplines of excellence- Clinical Research Incubation Project).

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Author notes

  1. Yu Shen and Tinghan Yang contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Guo Xue Xiang 37#, Chengdu, 610041, Sichuan Province, China

    Yu Shen, Tinghan Yang, Wenjian Meng & Ziqiang Wang

Authors
  1. Yu Shen
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  2. Tinghan Yang
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection and analysis were performed by Yu Shen and Tinghan Yang. The first draft of the manuscript was written by Yu Shen and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ziqiang Wang.

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Ethical Approval

For this type of study, formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Key points

• Surgical interventions could relieve the obstruction-related symptoms of Re-SMAS.

• For dyspepsia-related symptoms, Surgical interventions have an indefinite effect.

• Surgery is recommended for Re-SMAS patients with obstruction-related symptoms.

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Shen, Y., Yang, T., Meng, W. et al. Surgical Intervention Could Relieve Obstruction-Related Symptoms of Refractory Superior Mesenteric Artery Syndrome: Long-Term Follow-up Results. OBES SURG 33, 1073–1082 (2023). https://doi.org/10.1007/s11695-023-06478-6

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