No abstract
The article presents the main stages of the development of ideas about a fairly rare pathology in clinical practice the syndrome of compression of the ventral trunk. Until the mid-nineteenth century, reports of the clinical picture of chronic abdominal ischemia were more descriptive. Serial pathoanatomic studies, comparison of anatomical features revealed at autopsy with clinical manifestations accompanying these changes, contributed to the isolation of chronic ischemic disease of the digestive system in a separate nosological form. The discovery of angiography contributed to the significant development of vascular surgery and the isolation of the ventral trunk compression syndrome as an independent disease, since it allowed for a lifetime comparison of the detected changes in blood vessels with the clinical manifestations of the disease. The term ventral trunk compression syndrome was first introduced by P. Harjola when describing a case of abdominal pain in a patient with compression of the ventral trunk by the neuroganglionic tissue of the ventral plexus. Later, J. Dunbar confirmed the Association of clinical manifestations of chronic abdominal pain with compression of the ventral trunk by the median arched ligament of the diaphragm. In English-language literature, the disease was named Dunbar syndrome. The effectiveness of eliminating the symptoms of this disease by surgical dissection of compression structures has been proven. Further study of this problem developed in parallel with the development of surgery in General in accordance with the emergence and introduction of new surgical technologies. The purpose of numerous studies was to study the etiopathogenetic mechanisms of the occurrence of a variety of clinical manifestations of this syndrome and improve the results of its treatment by improving known surgical techniques and introducing new ones.
The OBJECTIVE was to study the efficacy and safety of laparoscopic decompression of the celiac trunk.METHODS AND MATERIALS. A comparative analysis of the results of laparoscopic (30 patients) and conventional decompression of the celiac trunk (50 patients) was carried out. All patients were operated on between September 2018 and July 2021.RESULTS. Intraoperative bleeding during laparoscopic decompression of the celiac trunk, which required conversion of access to laparotomy and vascular suture, was noted in 2 (6.7 %) cases. With conventional access, there were no such complications. The average duration of laparoscopic decompression of the celiac trunk was 107 minutes, from conventional access – 150 minutes. The average length of hospital stay after laparoscopic intervention was 4 days, after the traditional one – 7 days. Long-term results of treatment over a period of more than 6 months were evaluated in 28 patients who underwent laparoscopic decompression of the celiac trunk and 45 people who underwent conventional decompression. Ultrasound examination in all cases stated the return of linear and velocity parameters of blood flow in the celiac trunk to normal. complete relief of the clinical manifestations of the disease was achieved in 24 (85.7 %) patients after laparoscopic and in 39 (86.7 %) after traditional intervention.CONCLUSION. Laparoscopic decompression of the celiac trunk is an effective method of surgical treatment of the syndrome of compression of the celiac trunk, but there are risks of vascular damage. The long-term results of laparoscopic and open decompression of the celiac trunk are comparable.
The celiac trunk compression syndrome and the gastroesophageal reflux disease are quite common pathological conditions in the population of economically developed countries. The frequency of combining and the semiotics these illness has not been studied. There are no approaches to the diagnosis and treatment of gastroesophageal reflux disease, which developed on background of chronic ischemia of the abdominal cavity organs due to occlusion of the celiac trunk. Few papers devoted to this subject are limited to a small series of clinical observations without a detailed understanding of the problem and finding answers to these questions. The article presents an analysis of the clinical manifestations and results of instrumental diagnosis in 84 patients with a combination of the celiac trunk compression syndrome and the gastroesophageal reflux disease treated from 2011 to 2015 years. In this work the main symptoms characteristic of both diseases combination have been identified. A detailed description and characteristic of the basic methods of diagnostics are given. A practical algorithm for the detection of gastroesophageal reflux disease links with the celiac trunk compression syndrome is presented and justified in approach.
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