A predictive model for patients with median arcuate ligament syndrome

Brody, Fred; Randall, James A; Amdur, Richard L.; Sidawy, Anton N.

doi:10.1007/s00464-018-6240-y

Cited by 11 publications

(13 citation statements)

References 35 publications

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“…Similarly, Cienfuegos' study identified that patients with severe stenosis (>70%) experienced full resolution of symptoms in 71% of cases 16 . Brady's model further established that age and increased pre‐operative expiratory coeliac artery velocity were significant predictors of clinical improvement 17 . In our cohort, we reported a favourable post‐operative outcome for all patients with the same risk factors in conjunction with a low GSRS and VISICK score resulting in an early return to normal physical activities.…”

Section: Discussionsupporting

confidence: 74%

“…16 Brady's model further established that age and increased pre-operative expiratory coeliac artery velocity were significant predictors of clinical improvement. 17 In our cohort, we reported a favourable post-operative outcome for all patients with the same risk factors in conjunction with a low GSRS and VISICK score resulting in an early return to normal physical activities. Likewise, Ho reported that post-exertional pain and low VISICK scores were significantly associated with a high successful curative rate, whereas, abdominal pain at rest and vomiting along with higher VISICK scores were significantly associated with poorer outcomes.…”

Section: Discussionsupporting

confidence: 51%

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A diagnostic workup and laparoscopic approach for median arcuate ligament syndrome

Diab

Berney

2022

ANZ Journal of Surgery

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Background: Median arcuate ligament syndrome (MALS) is a rare disorder characterized by the compression of the coeliac trunk and plexus by fibrous arches of the median ligament. It commonly occurs in young women with postprandial epigastric pain, weight loss and nausea. We present a single surgeon experience on the diagnostic approach and management of MALS with a focus on laparoscopic surgery. Methods: A retrospective review of adult patients diagnosed with MALS during a 10-year period (2011-2021) was conducted at Bankstown-Lidcombe hospital in New South Wales, Australia.Results: MALS was diagnosed in six patients (mean 46 years, range: 27-74 years old), all confirmed on mesenteric duplex ultrasound and computed tomography angiography. The most common presentations were women with post-prandial pain, exercise induced pain and an average weight loss of 14.5 kg. The median interval from onset of symptoms to surgical referral was 10.5 months. The average BMI was 24.1 kg/m 2 and most had a grade III American Society of Anaesthesiologist physical status. All patients underwent laparoscopic release of median arcuate ligament with one patient requiring endovascular stenting. The mean operative time was 119 minutes with two minor post-operative complications, but no mortalities. The median hospital length of stay was 3.5 days with a median follow up of 3.5 years. Conclusion: Laparoscopic median arcuate ligament release with endovascular support for selected cases provides sound clinical resolution of symptoms and long-term results.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionsupporting

confidence: 51%

A diagnostic workup and laparoscopic approach for median arcuate ligament syndrome

Diab

Berney

2022

ANZ Journal of Surgery

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“…Algumas controvérsias acompanham a síndrome, visto que aspectos do diagnóstico e tratamento não estão bem estabelecidos 2,5,13,15 . A maioria dos achados na literatura estão sedimentados em relatos de caso ou séries com poucos pacientes, mas os autores apontam a compressão do tronco celíaco pelo ligamento arqueado 4 , como a principal causa, presente em até 24% dos pacientes 13 . A incidência é estimada em 2/100.000 habitantes 11 .…”

Section: Discussionunclassified

Abordagem Videolaparoscópica Na Síndrome De Dunbar

MÁXIMO

RAMOS

RIBAS

et al. 2022

RMP

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“…To achieve this, both pre-and postoperative adjunctive therapies, along with the use of arterial reconstruction and stenting were used more often in these studies. [23][24][25][26][27][28][29] Therefore, the current literature makes accurate comparison of outcomes between pure treatment modalities difficult. The data also showed an increased conversion rate to open in laparoscopic studies compared to the data presented here.…”

Section: Literature Review and Summarymentioning

confidence: 99%

“…The data also showed an increased conversion rate to open in laparoscopic studies compared to the data presented here. [23][24][25][27][28][29]…”

Section: Literature Review and Summarymentioning

confidence: 99%

Robotic Surgery for Median Arcuate Ligament Syndrome

Fernstrum

Pryor

Wright

et al. 2020

JSLS

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Background: Compression of the celiac artery by the median arcuate ligament results in median arcuate ligament syndrome (MALS). Using a consecutive cohort of patients with MALS, this study evaluated the efficacy and safety of robotic median arcuate ligament release (MALR). Methods: A retrospective chart review was performed on patients who underwent robotic MALR from August 2012 to April 2018. Patient workup included history and physical examination, mesenteric Doppler ultrasound, and CT (Computed Tomography) scan. Outcomes included pain improvement, length of stay, operation duration, narcotic use, and postoperative complications. Results: Twenty-seven patients met inclusion criteria. Two thirds of the cohort were female and the mean age was 49 Ϯ 15.5 years. Postprandial abdominal pain was the most common preoperative symptom (25/27, 93%). CT (Computed Tomography) was performed in 24 (89%), and celiac stenosis Ͼ 70% was observed in all. Operative duration was 95 minutes on average (range, 53-358 minutes), and in 24/27 (89%) patients, estimated blood loss was Ͻ 100 mL. Eighty-one percent of patients were discharged the day of surgery (22/27). Two cases were converted to open, with only one major complication occurring. At 30 or more days postoperation, 17 patients (68%) had full, 1 (4%) partial, and 1 (4%) no symptom resolution, 6 (24%) had symptom recurrence after initially having resolution. Fifty-six percent achieved narcotic liberation 9/16 (56%). Conclusions: Robotic MALR is a safe option for treatment of MALS with high response rates, early hospital discharge, and opportunity for narcotic liberation.

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A predictive model for patients with median arcuate ligament syndrome

Cited by 11 publications

References 35 publications

A diagnostic workup and laparoscopic approach for median arcuate ligament syndrome

A diagnostic workup and laparoscopic approach for median arcuate ligament syndrome

Abordagem Videolaparoscópica Na Síndrome De Dunbar

Robotic Surgery for Median Arcuate Ligament Syndrome

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