Laparoscopic extravascular renal vein stent placement for nutcracker syndrome
10.3760/cma.j.issn.1000-6702.2011.04.014
- VernacularTitle:腹腔镜下左肾静脉外支架固定术治疗左肾静脉压迫综合征的临床分析
- Author:
Dahong ZHANG
;
Qi ZHANG
;
Feng LIU
;
Yuelong ZHANG
;
Lijun WAN
- Publication Type:Journal Article
- Keywords:
Nutcracker syndrome;
Laparoscopes;
Extravascular stenting;
Renal veins;
Hematuria
- From:
Chinese Journal of Urology
2011;32(4):262-264
- CountryChina
- Language:Chinese
-
Abstract:
Objective To report the experience in the use of laparoscopic extravascular stent for the treatment of the nutcracker syndrome. Methods Five patients (4 men and 1 woman) aged 20 to 35 years (mean 25) underwent laparoscopic extravascular stent of the left renal vein (LRV) for treatment of nutcracker syndrome associated with severe recurrent gross hematuria and left gonadal vein varices. All patients met the criteria for establishing the diagnosis of nutcracker syndrome. Ultrasonography, computed tomography, and magnetic resonance imaging revealed visible entrapment of the LRV between the superior mesenteric artery and aorta. Bleeding from the left ureteral orifice was detected by cystoscopy in 3 cases. An externally reinforced graft was selected to form an external stent around the LRV to relieve the compression. Results The mean operation time was 67 min (65-70min). No complications occurred during surgery. The postoperative follow-up was 9 to 39 months (mean 28). Total relief was achieved in 4 men without a relapse of symptoms and abnormalities were not found in urine tests. There was partial relief for the female patient due to microscopic hematuria after the operation. In all the 5 cases, Color Doppler ultrasonography showed that the blood outflow was smooth, the inner diameter and flow velocity of the aortomesenteric portion of the LRV were both decreased, and the gonadal vein varices had diminished in diameter. Conclusions The laparoscopic extravgscular stent of the renal vein could be a feasible approach for re-establishing free renal venous outflow in patients with nutcracker syndrome. This slightly invasive treatment could eliminate the symptoms of the condition.
