Khirurgiia · 2025
[Surgical treatment of children with celiac axis compression syndrome].
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Zainulabidov R A, Razumovsky A Yu, Mitupov Z B, Chumakova G Yu, Teplov V O, Titova E A, Zolotareva L S
Аннотация
OBJECTIVE: To establish the indications for surgical treatment of celiac axis compression syndrome (CACS) in childhood, efficacy of laparoscopic decompression in these patients, possible complications and risks of surgical treatment.
MATERIAL AND METHODS: A total of 148 patients aged 4-17 years underwent surgical treatment for CACS between 2015 and 2023. Of these, 92 patients were followed-up in long-term postoperative period. The leading clinical manifestation was abdominal pain. The diagnosis was based on anamnesis, physical examination, Doppler ultrasound of celiac axis with blood flow velocity measurement, endoscopic ultrasonography and angiography. After examination, all patients underwent celiac axis decompression. According to intraoperative data, the main cause of celiac axis compression was the median arcuate ligament combined with neurofibrous tissue of celiac plexus.
RESULTS: Mean surgery time was 55 min. Intraoperative blood loss did not exceed 5-30 ml. There were 2 conversions. Patients were discharged. Postoperative examination was performed in 3-36 months after full recovery.
CONCLUSION: The authors identified the indications for surgical treatment of CACS, estimated clinical status of patients in pre- and postoperative period, proposed the diagnostic and treatment algorithm, as well as described the benefits of laparoscopic celiac axis decompression in children. Our experience demonstrates the possibility of early diagnosis of CACS and successful laparoscopic treatment.
MATERIAL AND METHODS: A total of 148 patients aged 4-17 years underwent surgical treatment for CACS between 2015 and 2023. Of these, 92 patients were followed-up in long-term postoperative period. The leading clinical manifestation was abdominal pain. The diagnosis was based on anamnesis, physical examination, Doppler ultrasound of celiac axis with blood flow velocity measurement, endoscopic ultrasonography and angiography. After examination, all patients underwent celiac axis decompression. According to intraoperative data, the main cause of celiac axis compression was the median arcuate ligament combined with neurofibrous tissue of celiac plexus.
RESULTS: Mean surgery time was 55 min. Intraoperative blood loss did not exceed 5-30 ml. There were 2 conversions. Patients were discharged. Postoperative examination was performed in 3-36 months after full recovery.
CONCLUSION: The authors identified the indications for surgical treatment of CACS, estimated clinical status of patients in pre- and postoperative period, proposed the diagnostic and treatment algorithm, as well as described the benefits of laparoscopic celiac axis decompression in children. Our experience demonstrates the possibility of early diagnosis of CACS and successful laparoscopic treatment.