Patient-Reported Outcomes for Robot-Assisted Laparoscopic Extravascular Renal Vein Stent Placements for Nutcracker...

Area of Science:

• Vascular Surgery
• Minimally Invasive Procedures
• Patient-Reported Outcomes

Background:

• Nutcracker phenomenon involves left renal vein compression by the superior mesenteric artery and aorta.
• Nutcracker syndrome is diagnosed when this phenomenon causes symptoms.
• Robot-assisted laparoscopic extravascular renal vein stent (RALERVS) placement is a potential treatment.

Purpose of the Study:

• To assess patient-reported outcomes following RALERVS placement for nutcracker syndrome.
• To evaluate the effectiveness of RALERVS in a single-institution cohort.

Main Methods:

• Retrospective review of 18 patients undergoing RALERVS between 2016 and 2022.
• Patient symptoms assessed via Likert scale questionnaire at least 3 months postoperatively.
• Comparison of pre- and postoperative symptom scores.

Main Results:

• Twelve of 18 patients responded, with a mean follow-up of 2.6 years.
• Significant improvement reported in flank pain, abdominal pain, nausea, headaches, back pain, pelvic pain, and early satiety (p < 0.05).
• Ten out of 12 respondents would recommend RALERVS.

Conclusions:

• RALERVS is an effective treatment option for nutcracker syndrome.
• The procedure leads to significant, multi-domain symptom improvement in patients.
• Further research is needed to determine the long-term durability of the RALERVS graft.