Small bowel autotransplantation after resection of lesions involving the roots of mesenteric vessels / 中华普通外科杂志

ABSTRACT

Objective:To summarize our experience in 13 cases of intestinal autotransplantation (IATx) after resection of lesions involving the roots of mesenteric vessels.Methods:The clinical data of 13 patients undergoing IATx in Xijing hospital were retrospectively analyzed. The etiology, surgical procedure and complications were analyzed. The patients were followed up by telephone and regular evaluations.Results:All 13 cases of IATx were successfully completed. For 12 patients who were diagnosed with tumors involving the mesenteric roots, the tumors were removed for cure intent avoiding massive intestinal resection. Pancreaticoduodenectomy was carried out simultaneously in 11 cases. The postoperative complication rate was 85% (11/13). The autograft was resected in 1 patient on the 1st postoperative day due to necrosis from mesenteric thrombosis, leading to short bowel syndrome. One-year survival was 69% (9/13). Among 4 deaths, 1 patient died of liver metastasis, and another died of liver and lung metastases. Five patients were alive 2 years postoperatively.Conclusion:IATx while-technically challenging, avoiding short small bowel syndrome in properly selected patients after resection of lesions especially benign ones involving the roots of mesenteric vessels that were traditionally considered to be "unresectable".