Wang Sheng-zheng, Zhang Wei-xing, Meng Qing-jun, Zhang Xue-pei, Wei Jin-xing, Qiao Bao-ping
Department of Urology, The First Affiliated Hospital, Zhengzhou University , Zhengzhou, China .
J Endourol. 2015 Sep;29(9):1025-9. doi: 10.1089/end.2014.0411. Epub 2015 Jul 13.
To report our techniques and experience of laparoscopic extravascular stent placement for nutcracker syndrome.
This study included 13 nutcracker syndrome patients who were treated by laparoscopic extravascular stent placement from June 2009 to August 2013. Clinical and surgical data and short-term outcomes were analyzed retrospectively.
The average duration of the operation was 72 minutes and the average blood loss was 30 mL. The average postoperative length of stay was 6 days. Retroperitoneal hematoma was relieved by conservative therapy in one patient. The postoperative computed tomography showed that the blood outflow of the left renal vein was smooth and the inner diameter was also decreased. The gonadal vein varices diminished in diameter in four patients. The follow-up was 8-52 months (mean 32.6); symptoms resolved in 10 patients and improved in 2 patients. One patient developed recurrent gross hematuria because of migration of the extravascular stent.
Laparoscopic extravascular stent placement appears feasible and safe and it is a minimally invasive alternative to open surgery.
报告我们腹腔镜下血管外支架置入治疗胡桃夹综合征的技术及经验。
本研究纳入了2009年6月至2013年8月间接受腹腔镜下血管外支架置入治疗的13例胡桃夹综合征患者。对临床及手术资料和短期预后进行回顾性分析。
手术平均时长为72分钟,平均失血量为30毫升。术后平均住院时间为6天。1例患者的腹膜后血肿经保守治疗后缓解。术后计算机断层扫描显示左肾静脉血流顺畅,内径也减小。4例患者的性腺静脉曲张直径缩小。随访时间为8 - 52个月(平均32.6个月);10例患者症状消失,2例患者症状改善。1例患者因血管外支架移位出现复发性肉眼血尿。
腹腔镜下血管外支架置入术似乎可行且安全,是开放手术的一种微创替代方法。