Abstract：Objective To explore the clinical efficacy of left renal vein transposition for the treatment of nutcracker syndrome without blocking the renal artery.Methods Clinical data (surgery group) of 10 patients with nutcracker syndrome admitted to the Department of Urology, Shandong Provincial Third Hospital from January 1999 to January 2017 were refrospectively analyzed. There were 8 males and 2 females, aged 22-53(39.9±10.5) years old. All the patients were performed left renal vein transposition without blocking renal artery. Observations included the operation time, intraoperative blood loss, postoperative drainage, extubation time, blocking time of renal vein, and the time of disappearance of gross hematuria. Furthermore, vascular diameter and blood flow velocity of the patients were compared before and after surgery. Ten healthy adults from the health management center of our hospital were randomly selected as the control group in July 2016, including 5 males and 5 females with an aged of 21-45 (37.0±5.8) years old. Then, left renal vein diameter and blood flow velocity were compared between the postoperative surgery group and the control group.Results In surgery group, the operative time was (171.0±10.8) min, intraoperative bleeding was (138.0±42.1) mL, blocking time of renal vein was (9.5±1.3)min, postoperative drainage was (130.0±24.5) mL, and extubation time was (3.3±0.8) d, the disappearance time of macroscopic hematuria was (4.2±1.2) days, and the disappearance time of microscopic hematuria was (7.3±1.1) days. Ten patients were followed up for 2-6 months with an average of 3 months. Ten patients had no hematuria or proteinuria after surgery. The inner diameter of the stenosis segment was increased, and the blood flow velocity was decreased. Before operation, the internal diameter and blood flow velocity of different stenosis segments and dilatation segments were compared. The Results were statistically significant (all P values＜0.01). Internal diameter and the blood flow velocity of different stenosis or dilatation segments in the final follow-up were compared with those in preoperation. After operation, the stenosis segments of left renal vein was improved. There was no significant difference in the internal diameter and blood flow velocity between the surgery group and the control group (all P values＞0.05).Conclusions The left renal vein transposition without blocking the renal artery is a reliable and effective treatment for the Nutcracker syndrome.
程琳, 付茂辉, 郝俊文,. 不阻断肾动脉左肾静脉移位术治疗胡桃夹综合征的临床疗效观察[J]. 中华解剖与临床杂志, 2018, 23(4): 328-332.
Cheng Lin, Fu Maohui, Hao Junwei.. Clinical observation of left renal vein transposition with no-blocking renal artery in the treatment of renal nutcracker syndrome. Chinese Journal of Anatomy and Clinics, 2018, 23(4): 328-332.
Kim KW, Cho JY, Kim SH, et al. Diagnostic value of computed tomographic findings of nutcracker syndrome: correlation with renal venography and renocaval pressure gradients[J]. Eur J Radiol, 2011, 80(3): 648-654. DOI:10.1016/j.ejrad.2010.08.044
2018, Vol. 23 
