Background: Median arcuate ligament syndrome is a rare condition with abdominal symptoms. Accepted\ntreatment options are open release of median arcuate ligament, laparoscopic release of edian arcuate ligament,\nrobot-assisted release of median arcuate ligament and open vascular treatment. Here we aimed to evaluate the\ncentral priority of open vascular therapy in the treatment of median arcuate ligament syndrome.\nMethods: We conducted a monocentric retrospective study between January 1996 and June 2016. Thirty-one\npatients with median arcuate ligament syndrome underwent open vascular surgery, including division of median\narcuate ligament in 17 cases, and vascular reconstruction of the celiac artery in 14 cases.\nResults: In a 20-year period, 31 patients (n = 26 women, n = 5 men) were treated with division of median arcuate\nligament (n = 17) or vascular reconstruction in combination with division of median arcuate ligament (n = 14). The\nmean age of patients was 44.8 Ã?± 15.13 years. The complication rate was 16.1% (n = 5). Revisions were performed in\n4 cases. The 30-day mortality rate was 0%. The mean in-hospital stay was 10.7 days. Follow-up data were obtained\nfor 30 patients. The mean follow-up period was 52.2 months (range 2ââ?¬â??149 months). Patients were grouped into a\ndecompression group (n = 17) and revascularisation group (n = 13). The estimated Freedom From Symptoms rates\nwere 93.3, 77.8, and 69.1% for the decompression group and 100, 83.3, and 83.3% for the revascularisation group after\n12, 24 and 60 months respectively. We found no significant difference in the Freedom From Re-Intervention CA rates\nof the decompression (100% at 12, 24 and 60 months post-surgery) and revascularisation (100% at 12 months, and 91.\n7% at 24 and 60 months post-surgery) groups during follow-up (p = 0.26).\nConclusions: Open vascular treatment of median arcuate ligament syndrome is a safe, low mortality-risk procedure,\nwith low morbidity rate. Treatment choice depends on the clinical and morphological situation of each patient.
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