{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T01:18:37Z","timestamp":1778548717858,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Superior Mesenteric Artery Syndrome (SMAS) is a very rare disease that causes starvation and malnutrition secondary to a mechanical obstruction of the 3\n                      <jats:sup>rd<\/jats:sup>\n                      portion of the duodenum between the superior mesenteric artery and aorta. Long-term outcomes following surgery for SMAS by current methods have a high failure rate of 21%-67%. We report the 3-year outcomes of a novel operation for SMAS described as the duodenoduodenostomy (DD).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is a longitudinal case series of 12 patients who underwent the DD operation for SMAS, comparing pre-surgery to post-surgery 3-year outcomes. Weight, Body Metabolic Index (BMI), iron levels, and subjective data were collected to assess restoration of nutrition, correction of malabsorption, and lifestyle. The Wilcoxon signed-rank test was applied to nonparametric matched or dependent samples, with statistical significance set at\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At the end of 3 years, there was a significant increase in median weight and BMI, at 108 lbs vs 123.1 lbs (\n                      <jats:italic>P<\/jats:italic>\n                      -value 0.0156) and a BMI of 18.57 vs 20.59 (\n                      <jats:italic>P<\/jats:italic>\n                      -value 0.0161). At 3 months, iron levels normalized after surgery and stayed normal at 45 mcg\/dL vs 130 mcg\/dL (\n                      <jats:italic>P<\/jats:italic>\n                      -value = 0.046). After 3 years, 75% of patients gained weight and BMI while 83% were able to maintain their BMI to a normal range.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study demonstrates that DD surgery leads to significant increases in weight and BMI, accompanied by improved iron levels. The DD procedure emerges as a promising surgical option in the definitive treatment for SMAS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348241300361","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T23:52:53Z","timestamp":1732146773000},"page":"561-569","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Outcomes After Duodenoduodenostomy for Superior Mesenteric Artery Syndrome"],"prefix":"10.1177","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0129-0390","authenticated-orcid":false,"given":"Darwin","family":"Ang","sequence":"first","affiliation":[{"name":"Department of Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, USA"},{"name":"College of Medicine, University of Central Florida, Orlando, FL, USA"},{"name":"Department of Surgery, HCA Florida Ocala Hospital, Ocala, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alana","family":"Hofmann","sequence":"additional","affiliation":[{"name":"Department of Surgery, Transplant Surgery, University of Cincinnati, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelrahman","family":"Attili","sequence":"additional","affiliation":[{"name":"General Surgery, Hepatobiliary Surgery, CHI St. Vincent, Little Rock, AK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Whiyie","family":"Sang","sequence":"additional","affiliation":[{"name":"General Surgery, Colorectal Surgery, Novant Health, Wilmington, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6014-3252","authenticated-orcid":false,"given":"Tandis","family":"Soltani","sequence":"additional","affiliation":[{"name":"Department of Surgery, Acute Care Surgery, UC Davis, Sacramento, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winston","family":"Richards","sequence":"additional","affiliation":[{"name":"Department of Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, USA"},{"name":"College of Medicine, University of Central Florida, Orlando, FL, USA"},{"name":"Department of Surgery, HCA Florida Ocala Hospital, Ocala, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Ferber","sequence":"additional","affiliation":[{"name":"Department of Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, USA"},{"name":"College of Medicine, University of Central Florida, Orlando, FL, USA"},{"name":"Department of Surgery, HCA Florida Ocala Hospital, Ocala, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3083-9555","authenticated-orcid":false,"given":"Dana","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, USA"},{"name":"College of Medicine, University of Central Florida, Orlando, FL, USA"},{"name":"Department of Surgery, HCA Florida Ocala Hospital, Ocala, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1956.01280020110022"},{"key":"e_1_3_4_3_2","first-page":"793","article-title":"Chronic duodenal ileus","volume":"12","author":"Wilkie DP","year":"1921","unstructured":"Wilkie DP. Chronic duodenal ileus. The British Medical Journal. 1921;12:793-795.","journal-title":"The British Medical Journal"},{"issue":"2","key":"e_1_3_4_4_2","first-page":"90","article-title":"Superior mesenteric artery syndrome: CT and ultrasonography findings","volume":"11","author":"Unal B","year":"2005","unstructured":"Unal B, Akta\u015f A, Kemal G, et al. Superior mesenteric artery syndrome: CT and ultrasonography findings. Diagn Interv Radiol. 2005;11(2):90-95.","journal-title":"Diagn Interv Radiol"},{"issue":"2","key":"e_1_3_4_5_2","first-page":"141","article-title":"Superior mesenteric artery compression syndrome","volume":"70","author":"Lee CS","year":"1978","unstructured":"Lee CS, Mangla JC. Superior mesenteric artery compression syndrome. Am J Gastroenterol. 1978;70(2):141-150.","journal-title":"Am J Gastroenterol"},{"key":"e_1_3_4_6_2","volume-title":"StatPearls [Internet]","author":"Van Horne N","year":"2024","unstructured":"Van Horne N, Jackson JP. Superior mesenteric artery syndrome. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024-. 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