Pierre-Vincent Campello, Emilien Seizilles de Mazancourt, Sacha Hollanders, Nicolas Terrier, Nadia Abid, Xavier Matillon, Lionel Badet, Sébastien Crouzet
{"title":"Robotic-assisted Kidney Autotransplantation for Nutcracker Syndrome: Surgical Technique and Results","authors":"Pierre-Vincent Campello, Emilien Seizilles de Mazancourt, Sacha Hollanders, Nicolas Terrier, Nadia Abid, Xavier Matillon, Lionel Badet, Sébastien Crouzet","doi":"10.1016/j.eururo.2025.08.016","DOIUrl":null,"url":null,"abstract":"<h3>Background and objective</h3>The nutcracker syndrome is a rare condition that occurs in young patients and can cause severe flank pain. The available surgical techniques often carry a risk of complications or morbidity. This study aims to describe robotic-assisted kidney autotransplantation for nutcracker syndrome and show its efficacy and safety.<h3>Methods and surgical procedure</h3>A retrospective study of all patients managed in our center by robotic-assisted kidney autotransplantation for symptomatic nutcracker syndrome was carried out. Patient demographics, operative time, hospitalization time, complications, management of postoperative pain, and patient-reported outcome measures (PROMs) were assessed.<h3>Key findings and limitations</h3>Thirty-four patients (30 female and four male) underwent surgery between January 2015 and December 2024, with a median age of 35 (Q1–Q3: 27–43) yr and a median body mass index of 20 kg/m<sup>2</sup>. The median operative time was 314 (Q1–Q3: 265–350) min, and the median hospital stay was 3 d. One procedure was converted to open surgery. Seven patients (21%) experienced complications within 3 mo, including five minor (Clavien-Dindo grade <3) and two major (Clavien-Dindo ≥3) complications, one of which required a nephrectomy. The median follow-up was 15 (Q1–Q3: 6–30) mo. PROMs were available for 29 patients. Nine patients (31%) reported complete symptom relief, 17 (59%) partial improvement, and three (10%) partial worsening of their symptoms.<h3>Conclusions and clinical implications</h3>Robotic-assisted kidney autotransplantation can be a therapeutic option for the treatment of nutcracker syndrome, but it should be performed in an expert center for transplantation and robotic surgery. Further studies and long-term follow-up are needed.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"157 1","pages":""},"PeriodicalIF":25.2000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.eururo.2025.08.016","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objective
The nutcracker syndrome is a rare condition that occurs in young patients and can cause severe flank pain. The available surgical techniques often carry a risk of complications or morbidity. This study aims to describe robotic-assisted kidney autotransplantation for nutcracker syndrome and show its efficacy and safety.
Methods and surgical procedure
A retrospective study of all patients managed in our center by robotic-assisted kidney autotransplantation for symptomatic nutcracker syndrome was carried out. Patient demographics, operative time, hospitalization time, complications, management of postoperative pain, and patient-reported outcome measures (PROMs) were assessed.
Key findings and limitations
Thirty-four patients (30 female and four male) underwent surgery between January 2015 and December 2024, with a median age of 35 (Q1–Q3: 27–43) yr and a median body mass index of 20 kg/m2. The median operative time was 314 (Q1–Q3: 265–350) min, and the median hospital stay was 3 d. One procedure was converted to open surgery. Seven patients (21%) experienced complications within 3 mo, including five minor (Clavien-Dindo grade <3) and two major (Clavien-Dindo ≥3) complications, one of which required a nephrectomy. The median follow-up was 15 (Q1–Q3: 6–30) mo. PROMs were available for 29 patients. Nine patients (31%) reported complete symptom relief, 17 (59%) partial improvement, and three (10%) partial worsening of their symptoms.
Conclusions and clinical implications
Robotic-assisted kidney autotransplantation can be a therapeutic option for the treatment of nutcracker syndrome, but it should be performed in an expert center for transplantation and robotic surgery. Further studies and long-term follow-up are needed.
期刊介绍:
European Urology is a peer-reviewed journal that publishes original articles and reviews on a broad spectrum of urological issues. Covering topics such as oncology, impotence, infertility, pediatrics, lithiasis and endourology, the journal also highlights recent advances in techniques, instrumentation, surgery, and pediatric urology. This comprehensive approach provides readers with an in-depth guide to international developments in urology.