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  • Title: [The prevention of the aorto-mesenteric compression syndrome in interventions for ileoanal anastomoses].
    Author: Tonelli F, Anastasi A, Mazzoni P, Batignani G, Monaci I, Ferretti P, Ficari F.
    Journal: Ann Ital Chir; 1993; 64(6):675-8; discussion 679. PubMed ID: 8080158.
    Abstract:
    Restorative proctocolectomy with ileal-anal anastomosis can induce a duodenal stenosis due to the compression between superior mesenteric artery (SMA) and aorta when the ileum is pulled-down to the anus stretching the SMA. This situation may require prolonged nasogastric intubation or even surgery. In our experience this occurred in 10% of pts. Aiming to avoid this complication we have performed an intestinal derotation just before ileal-anal anastomosis abolishing any possibility of duodenal compression. Comparing this latter group of patients to those who didn't receive intestinal derotation, we observed a significant reduction of nasogastric tube drainage and of the nasogastric intubation time. We think that intestinal derotation could be effective in preventing SMA syndrome after restorative proctocolectomy and ileal-anal anastomosis.
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