Duodenojejunostomy versus Distal Gastrectomy and Roux-en-Y Gastrojejunostomy in Management of Superior Mesenteric Artery Syndrome: Retrospective Cohort Study.

Abstract

Introduction: Superior mesenteric artery (SMA) syndrome is a rare gastrointestinal disorder characterized bycompression of the third part of the duodenum between the abdominal aorta and SMA.Aim of work: To compare outcomes of duodenojejunostomy (Open/laparoscopic) versus distal gastrectomy withRoux-en-Y gastrojejunostomy (Open/laparoscopic) in managing SMA syndrome, focusing on symptoms relief andsurgical complications.Patients and methods: A retrospective cohort study with data analysis from 22 SMA syndrome patients admittedto Ain Shams University Hospital’s Upper GIT Unit from January 2021 to December 2024.Results: This study compared postoperative outcomes between duodenojejunostomy (Group A) and distalgastrectomy with Roux-en-Y gastrojejunostomy (Group B). Duodenojejunostomy resulted in shorter surgerydurations and hospital stays. Although reintervention rates were similar, vomiting and readmission rates werehigher in Group A. Group B demonstrated favorable long-term outcomes, with lower complication rates andreduced readmissions.Conclusion: Both surgical approaches effectively managed SMA syndrome symptoms. Duodenojejunostomyoffered shorter surgery and hospitalization times, while distal gastrectomy with Roux-en-Y gastrojejunostomyreduced postoperative vomiting and complications, suggesting potential long-term benefits.