Background: Acute thromboembolic occlusion of the superior mesenteric artery (SMA) has been associated with poor prognosis. The present study reports a single-center experience of surgical interventions in patients with acute occlusion of SMA.
Methods: This retrospective, observational study included patients who underwent surgical treatment for acute mesenteric ischemia due to thromboembolic occlusion of SMA. Short-term follow-up data included in-hospital morbidities and in-hospital mortality. Major in-hospital morbidities included peritonitis, sepsis or septic shock, multi-organ failure, re-occlusion of arteries, acute renal failure, re-exploration, and prolonged ventilation. Minor in-hospital morbidities were defined as the occurrence of ileus, surgical site infection, or any other complications that required further treatment or prolonged hospital stay. Long-term follow-up data included short bowel syndrome, readmission to hospital for reoccurrence of mesenteric ischemia, and death at 1-year follow-up.
Result: A total of 47 patients (average age 54.23±10.09 years) were included in the analysis. All the patients underwent exploratory laparotomy, with an average time from hospital admission to operation of 8.34±8.210 hrs. Except for three patients, all the patients needed bowel resection during the first surgical intervention. Open surgical revascularization with thromboembolectomy was attempted in 33 (70.2%) patients. Relook laparotomy was performed in 17 (n=17/47; 36.2%) patients. Five patients (n=2 further bowel resection; n= 3 resections at relook only) needed bowel resection during relook procedure. In-hospital and one-year mortality was 8.5% (n=4) and 36.2% (n=17), respectively.
Conclusion: The results of the study demonstrated that surgical intervention for acute arterial mesenteric ischemia due to thromboembolic occlusion of SMA is an effective treatment approach.