Clinical Observation Of Left Renal Vein Transposition With No-blocking Renal Artery In The Treatment Of Nutcracker Syndrome(Case Report Of 13 Cases)

objectiveTo investigate the etiology,clinical manifestations of nutcracker syndrome and treatment,to further improve the recognition of nutcracker syndrome.Analysis the no-blocking renal artery of left renal vein transposition surgery on clinical effect of nutcracker syndrome,improved treatment of nutcracker syndrome.MethodsThirteen cases of nutcracker syndrome in our hospital from January1999 to January 2014 were included,and the clinical documents were retrospectively analyzed.Among the 10 cases,the left renal vein transposition with no-blocking renal artery was performed.other 3 patients were treated conservatively.After follow-up(2-6 months),the average follow-up was 3 months.The etiology,clinical manifestation,auxiliary examination,diagnosis and treatment of the nutcracker syndrome were analyzed in combination with 13 cases of patients before and after treatment.To explore the advantages and disadvantages of the left renal vein transposition with no-blocking renal artery in the treatment of nutcracker syndrome and other methods of operation without block of artery.ResultsTen cases of patients with the average operation time was(171±10.8)minutes,the average amount of bleeding(138ml±42.1),the average post-operative drainage about(130±24.5)ml.The average post-operative drainage time was(3.3±0.8)days,gross hematuria disappeared for an average of(4.2±1.2)days,hematuria disappeared time was(7.3 ±1.1)days.Four cases of patients with post-operative hemoglobin rose to normal,proteinuria in the average 20 days was disappeared.Thirteen cases were followed up for 3 months,and there was no significant improvement in hematuria in 3 cases with conservative treatment.10 cases of surgical patients without bleeding,vascular thrombosis,infection and other abnormalities were not seen.The shape of the left ureter was normal,and there was no hematuria.The urine routine showed no recurrence of hematuria and proteinuria.3 cases with back pain was significantly improved,1 cases of patient with color Doppler ultrasound examination did not indicate the varicocele.The results of preoperative and post-operative color Doppler ultrasound examination in 10 patients were compared.The results indicated that the inner diameter of the stenosis was increased and the blood flow velocity decreased.In the operation group,10 cases of postoperative patients with color Doppler ultrasound examination results and the normal color Doppler ultrasound examination results for t examination,the two do not have statistical significance,the post-operative patients and normal people have no difference.The renal vein transposition with no-blocking the renal artery in the treatment of nutcracker syndrome have influence.It is worth promoting.ConclusionsThe incidence of the syndrome is relatively small,and the etiology is not clear.It is difficult to make a diagnosis according to clinical manifestations.Urinary tract ultrasound,urinary red blood cell morphology,CT and CTA examination.the cystoscopy is important in diagnosis of the nutcracker syndrome.At present,there are many methods to treat the nutcracker syndrome.The renal vein transposition with no-blocking renal artery in the treatment of nutcracker syndrome is one of the effective methods,which is worthy promoting.