TY - JOUR
T1 - Mesenteric traction syndrome - Incidence, impact, and treatment
T2 - A systematic scoping review of the literature
AU - Olsen, August A
AU - Bazancir, Laser A
AU - Dahl, Stig
AU - Fukumori, Daisuke
AU - Shiwaku, Hironari
AU - Svendsen, Lars Bo
AU - Achiam, Michael P
N1 - Copyright © 2022. Published by Elsevier Masson SAS.
PY - 2023
Y1 - 2023
N2 - BACKGROUND: Mesenteric traction syndrome (MTS) is commonly seen during major abdominal surgery and is characterised by facial flushing, hypotension, and tachycardia 15 min into surgery. MTS also impacts the postoperative course, as severe MTS has been associated with increased postoperative morbidity. However, despite MTS being common and severe MTS causing increased postoperative morbidity, the gaps in the literature are not clearly defined. We aimed to examine the diagnostic criteria, incidence, intraoperative and postoperative impact, and potential preventative measures of MTS while highlighting potential gaps in the literature.METHODS: We followed the Prisma guidelines and performed a systematic literature search. We included only human studies examining MTS. All hits were screened for title and abstract, followed by a full-text review by at least two authors for determining eligibility for inclusion. Data were extracted and risk of bias was assessed by two independent reviewers.RESULTS: A total of 37 studies, comprising 1102 patients were included in the review. The combined incidence of MTS during open abdominal surgery was found to be 76%, with 35% developing severe MTS. It was found that the development of MTS was associated with marked haemodynamic changes. It was also found that several different subjective diagnostic criteria exist and that severe MTS was associated with increased postoperative morbidity. Furthermore, several preventative measures for protecting against MTS have been examined, but only on the incidence of MTS and not on the postoperative course.CONCLUSION: MTS occurs in 76% of patients undergoing major abdominal surgery and is associated with deleterious haemodynamic effects, which are more pronounced in patients developing severe MTS. Severe MTS is also associated with a worse postoperative outcome. However, gaps are still present in the current literature on MTS.
AB - BACKGROUND: Mesenteric traction syndrome (MTS) is commonly seen during major abdominal surgery and is characterised by facial flushing, hypotension, and tachycardia 15 min into surgery. MTS also impacts the postoperative course, as severe MTS has been associated with increased postoperative morbidity. However, despite MTS being common and severe MTS causing increased postoperative morbidity, the gaps in the literature are not clearly defined. We aimed to examine the diagnostic criteria, incidence, intraoperative and postoperative impact, and potential preventative measures of MTS while highlighting potential gaps in the literature.METHODS: We followed the Prisma guidelines and performed a systematic literature search. We included only human studies examining MTS. All hits were screened for title and abstract, followed by a full-text review by at least two authors for determining eligibility for inclusion. Data were extracted and risk of bias was assessed by two independent reviewers.RESULTS: A total of 37 studies, comprising 1102 patients were included in the review. The combined incidence of MTS during open abdominal surgery was found to be 76%, with 35% developing severe MTS. It was found that the development of MTS was associated with marked haemodynamic changes. It was also found that several different subjective diagnostic criteria exist and that severe MTS was associated with increased postoperative morbidity. Furthermore, several preventative measures for protecting against MTS have been examined, but only on the incidence of MTS and not on the postoperative course.CONCLUSION: MTS occurs in 76% of patients undergoing major abdominal surgery and is associated with deleterious haemodynamic effects, which are more pronounced in patients developing severe MTS. Severe MTS is also associated with a worse postoperative outcome. However, gaps are still present in the current literature on MTS.
KW - Endothelial dysfunction
KW - Facial flushing
KW - Intraoperative hypotension
KW - Mesenteric traction syndrome
KW - Prostacyclin
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85140765003&partnerID=8YFLogxK
U2 - 10.1016/j.accpm.2022.101162
DO - 10.1016/j.accpm.2022.101162
M3 - Review
C2 - 36162787
SN - 2352-5568
VL - 42
SP - 1
EP - 19
JO - Anaesthesia, critical care & pain medicine
JF - Anaesthesia, critical care & pain medicine
IS - 1
M1 - 101162
ER -