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The present study analyzes the long\u2010term outcomes in 13 patients undergoing laparoscopic surgery for SMAS.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A retrospective study of 10 females and three males undergoing surgery between 2001 and 2013 was performed. Demographic, clinical and radiologic data and long\u2010term surgical outcomes were recorded. In 12 patients latero\u2010lateral duodenojejunostomy and in one patient distal laparoscopic gastrectomy with Roux\u2010en\u2010Y reconstruction were performed. The median age was 24 years (20\u201328), and the median duration of symptoms was 24\u00a0months (5\u201324). The most frequent symptoms were abdominal pain (<jats:italic>n<\/jats:italic>\u2009=\u200911; 92.3%), nausea and vomiting (<jats:italic>n<\/jats:italic>\u2009=\u200910; 77%) and weight loss (<jats:italic>n<\/jats:italic>\u2009=\u20099; 69.2%). The median operating time was 98\u00a0min (86\u2013138) and hospital stay was 3\u00a0days (1\u201314).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No reconversions occurred, and one patient experienced gastric emptying delay in the immediate postoperative period with spontaneous resolution. In four patients, SMAS was associated with severe stenosis of the celiac trunk which was treated in the same operation, and four patients presented stenosis of the left renal vein (the \u201cnutcracker\u201d phenomenon). With a median follow\u2010up of 94\u00a0months (SD 65.3), eight patients (61.5%) had excellent results. One patient had a relapse of symptoms 4 years after surgery requiring distal gastrectomy, two patients presented delay in gastric emptying following temporary improvement and one patient experienced no improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Latero\u2010lateral duodenojejunostomy yields good results in SMAS although it requires other gastric motility disorders to be ruled out for appropriate treatment to be established.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05413-5","type":"journal-article","created":{"date-parts":[[2020,2,6]],"date-time":"2020-02-06T17:03:01Z","timestamp":1581008581000},"page":"1798-1806","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Minimally Invasive Surgical Approach for the Treatment of Superior Mesenteric Artery Syndrome: Long\u2010Term Outcomes"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6767-0573","authenticated-orcid":false,"given":"Javier A.","family":"Cienfuegos","sequence":"first","affiliation":[{"name":"Department of General Surgery, Cl\u00ednica Universidad de Navarra School of Medicine University of Navarra Av. 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