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目的:探讨后腹腔镜前入路左肾静脉外支架固定术治疗胡桃夹综合征(NCS)的最初经验,并分享首例手术经验。方法:对1例成年男性NCS患者采用后腹腔镜前入路左肾静脉人工血管外支架置入固定术治疗,记录其手术过程并观察疗效。结果:手术顺利完成,无重要脏器和大血管损伤。手术时间80min,术中出血量50ml。术后肉眼血尿消失,无淋巴瘘等并发症。结论:经后腹腔前入路左肾静脉外支架固定术治疗NCS具有独特的优越性,可迅速抵达肾蒂大血管并容易暴露肾静脉,使支架置入变得简单易行。
Objective: To investigate the initial experience of retroperitoneal laparoscopic left renal vein stent in the treatment of nutcracker syndrome (NCS) and to share the first experience of surgery. Methods: One adult male patient with NCS underwent retroperitoneal laminectomy with left renal vein graft, and the operation was recorded and the curative effect was observed. Results: The operation was successfully completed without major organ damage and macrovascular injury. Surgery time 80min, intraoperative blood loss 50ml. Postoperative gross hematuria disappeared, no complications such as lymphatic fistula. Conclusion: The treatment of NCS by left anterior descending anastomosis with left renal vein stent possesses the unique superiority that it can quickly reach the large vessels of renal pedicle and expose the renal vein easily, which makes stent implantation easy.