The Value of Robotic-Assisted Combined Left Renal Vein and Proximal Gonadal Vein Transposition for Nutcracker Syndrome: Preliminary Experience From a Single Centre

IF 2.4 3区医学 Q2 SURGERY

International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2026-03-21 DOI:10.1002/rcs.70154

Hua Wang, Jinbin Xu, Qunxiong Huang, Zhanshen Huang, Samun Cheong, Zifeng Xu, Gengguo Deng, Tengcheng Li, Cheng Hu, Jinming Di

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引用次数: 0

Abstract

Background

This study compares outcomes of robotic Robotic-assisted left renal vein (LRV) transposition with and without proximal left gonadal vein (LGV) transposition for Nutcracker Syndrome (NCS).

Methods

A retrospective analysis was conducted on 24 NCS patients. Group A (n = 13) had LRV transposition. Group B (n = 11) had combined LRV+ proximal LGV transposition. Outcomes including operative details, complications, symptom resolution, and renocaval pressure gradient (RPG) reduction.

Results

Operative time and hospital stay were similar between the groups. However, group B had a higher lymphatic leakage rate (64% vs. 8%; p = 0.0078) and required longer drainage (median 5 vs. 3 days; p = 0.02). Clinical symptoms improved in both groups. Group B achieved substantially greater RPG reduction (70% ± 15% vs. 55% ± 8%; p = 0.004).

Conclusions

Robotic LRV and proximal LGV transposition for significant dilation is safe and effective. Despite higher short-term lymphatic morbidity, the combined approach offers greater reduction in RPG, providing a valuable alternative for selected patients.

Trial Registration

This research was also registered at the Chinese Clinical Trial Registry. The registration number is ChiCTR2500099335 (Link: https://www.chictr.org.cn/bin/project/edit?pid=261879)

查看原文本刊更多论文

机器人辅助左肾静脉与性腺近端静脉联合移位治疗胡桃夹子综合征的价值：来自单一中心的初步经验。

背景：本研究比较了机器人辅助左肾静脉（LRV）转位治疗胡桃夹子综合征（NCS）的结果，包括左性腺近端静脉（LGV）转位和不转位。方法：对24例NCS患者进行回顾性分析。A组（n = 13） LRV转位。B组（n = 11）合并LRV+近端llgv转位。结果包括手术细节、并发症、症状缓解和肾下腔压力梯度（RPG）降低。结果：两组手术时间和住院时间相近。然而，B组淋巴渗漏率较高（64%对8%，p = 0.0078），需要更长的引流时间（中位5天对3天，p = 0.02）。两组患者临床症状均有改善。B组实现了更大的RPG降低（70%±15% vs 55%±8%;p = 0.004）。结论：机器人LRV和近端llgv转位术用于显著扩张是安全有效的。尽管短期淋巴发病率较高，但联合入路可更大程度地减少RPG，为选定的患者提供了一个有价值的选择。试验注册：本研究已在中国临床试验注册中心注册。注册号：ChiCTR2500099335（链接：https://www.chictr.org.cn/bin/project/edit?pid=261879）。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.