Surgical treatment of nutcracker syndrome

Objective To improve the standard of understandings of nutcracker syndrome.Methods The data of 3 cases of nutcracker syndrome underwent transposition of the left renal vein were reviewed.Results Three patients all had complaints of hematuria.Blood flow of the proximal left renal vein was increased.The ratios of distal unrestricted interdiameter and proximal restricted were also increased(3),and even more after standing for 15 minutes in patients with nutcracker syndrome.The gross hematuria disappeared 2,5,and 4 days respectively after surgery,and microhematuria ceased spontaneously 4,6,and 6 days respectively after surgery.Transposition of the left vein effectively relieved the symptoms related to the letf renal vein nutcracker syndrome.The patients had no recurrence of symptoms following up during at least 4 months.Conclusion Doppler ultrasound is an effective tool to diagnose nutcracker syndrome before operation.Transposition of the left renal vein is a safe and effective surgical approach in the treatment of left renal vein nutcracker syndrome.