title: Laparoscopic lysis of the ligament of treitz for superior mesenteric artery syndrome.
abstract: BACKGROUND
  Superior mesenteric artery (SMA) syndrome (SMAS) is a rare condition caused by compression of the third portion of the duodenum by the SMA. The effect of the laparoscopic management of SMAS remains poorly understood. This study aimed to investigate the feasibility and effect of the laparoscopic management for SMAS.
  
  
  METHODS
  We retrospectively reviewed 19 cases of SMAS who underwent surgical interventions in The Third Affiliated Hospital of Sun Yat-sen University between June 2006 and October 2013, consisting of 8 cases of duodenojejunostomy (DJ) and 11 cases of laparoscopic lysis of the ligament of Treitz (LL-LOT). A telephone survey was conducted to collect the follow-up status.
  
  
  RESULTS
  Either DJ or LL-LOT was performed smoothly. The median operative time of the laparoscopic procedure and DJ was 56 and 95 min, respectively. Median blood loss was 10 versus 35 ml. Median postoperative hospital stays in both were 8 days. Ten cases of the laparoscopic group recovered uneventfully, while 1 case still presented symptoms of abdominal distention. Upper gastrointestinal fluoroscopy showed marked 'to-and-fro' peristalsis. An additional DJ was performed 35 days later to resolve her symptoms.
  
  
  CONCLUSIONS
  LL-LOT is simple, feasible, minimally invasive and effective for SMAS with no severe duodenum 'to-and-fro' peristalsis.
authors.affiliation: Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Jia-Feng
authors.initials: JF
authors.lastname: Fang
authors.forename: Bo
authors.initials: B
authors.lastname: Wei
authors.forename: Zong-Heng
authors.initials: ZH
authors.lastname: Zheng
authors.forename: Pu-Run
authors.initials: PR
authors.lastname: Lei
authors.forename: Tu-Feng
authors.initials: TF
authors.lastname: Chen
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D000792:Angiography / Q000379:methods; D002681:China; D015331:Cohort Studies; D004385:Duodenostomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007582:Jejunostomy / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D008022:Ligaments / Q000601:surgery*; D008297:Male; D056888:Patient Positioning; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013478:Superior Mesenteric Artery Syndrome / Q000175:diagnosis* / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D055815:Young Adult