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A predictive model for patients with median arcuate ligament syndrome.
- Source :
-
Surgical Endoscopy & Other Interventional Techniques . Dec2018, Vol. 32 Issue 12, p4860-4866. 7p. 4 Charts, 1 Graph. - Publication Year :
- 2018
-
Abstract
- <bold>Background: </bold>Due to the rarity of median arcuate ligament (MAL) syndrome, patient selection for surgery remains difficult. This study provides a predictive model to optimize patient selection and predict outcomes following a MAL release.<bold>Methods: </bold>Prospective data from patients undergoing a MAL release included demographics, radiologic studies, and SF-36 questionnaires. Successful postoperative changes in SF-36 was defined as an improvement > 10% in the total SF-36 score. A logistic regression model was used to develop a clinically applicable table to predict surgical outcomes. Celiac artery (CA) blood flow velocities were compared pre- and postoperatively and Pearson correlations were examined between velocities and SF-36 score changes.<bold>Results: </bold>42 patients underwent a laparoscopic MAL release with a mean follow-up of 28.5 ± 18.8 months. Postoperatively, all eight SF-36 scales improved significantly. The logistic regression model for predicting surgical benefit was significant (p = 0.0244) with a strong association between predictors and outcome (R2 = 0.36). Age and baseline CA expiratory velocity were significant predictors of improvement and predicted clinical improvement. There were significant differences between pre- and postoperative CA velocities. Postoperatively, the bodily pain scale showed the most significant increase (64%, p < 0.0001). A table was developed using age and preoperative CA expiratory velocities to predict clinical outcomes.<bold>Conclusions: </bold>Laparoscopic MAL produces significant symptom improvement, particularly in bodily pain. This is one of the first studies that uses preoperative data to predict symptom improvement following a MAL release. Age and baseline CA expiratory velocity can be used to guide postoperative expectations in patients with MAL syndrome. [ABSTRACT FROM AUTHOR]
- Subjects :
- *LIGAMENTS
*CELIAC artery
*LAPAROSCOPY
*TREATMENT effectiveness
*PREDICTION models
Subjects
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 32
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 132730699
- Full Text :
- https://doi.org/10.1007/s00464-018-6240-y