Laparascopic Ladd's procedure as treatment alternative, when parenteral or prolonged hospital nutrition is not an option for superior mesenteric artery syndrome

Abstract

ObjectivesSuperior mesenteric artery syndrome (SMAS) is an uncommon cause of duodenal obstruction in pediatric patients. It is extremely rare in young infants. The classic treatment for SMAS has been an open or laparoscopic duodenojejunostomy when conservative medical therapy failed to resolve the obstruction. We herein reported 3 cases of SMAS in infants treated by laparoscopic Ladd's procedure. The advantages and feasibility of laparoscopic Ladd's procedure applied for SMAS in infants were discussed. MethodsThree cases of infants with SMAS subjected to laparoscopic Ladd's procedure in our hospital were collected from January 2014 to December 2015. The patients' age, operative time, postoperative hospital observation, resumption of full diet, and postoperative complications were analyzed. ResultsThe median age at operation was 8 months (range, 6–9 months). The mean body weight was 7.9 kg (range, 6.5–8.8 kg). The mean operative time was 66.7 min (range, 65–75 min). The mean postoperative hospital stay was 4.3 days (range, 4–5 days) and the follow-up was 20.7 months (range, 12–34 months) without any specific postoperative complications. ConclusionBased on our reports, laparoscopic Ladd's procedure is a reliable and practicable minimally invasive surgery for in infants with SMAS.