{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:12:50Z","timestamp":1790413970209,"version":"4.1.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Nutcracker phenomenon is the compression of the left renal vein between the superior mesenteric artery (SMA) and the abdominal aorta. Nutcracker syndrome refers to the presence of nutcracker phenomenon with symptoms. Between 2016 and 2022, we performed 18 robot-assisted laparoscopic extravascular renal vein stent (RALERVS) placements. We sought to assess patient-reported outcomes of RALERVS placement by a single institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a single-center retrospective review of 18 patients with a minimum of 3 months follow-up. Symptoms were assessed utilizing a questionnaire conducted with a 5-point Likert scale at a minimum of 3 months postoperatively. Five on the Likert scale was severe while 1 was none. Primary study outcomes compared pre- and postoperative patient-reported symptom scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twelve out of 18 patients responded to the survey. The average length of time from date of operation to completion of survey was 2.6 years. Average age of the cohort was 36 years with a mean BMI of 19.4\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . There was only one man. Mean operative time was 137 minutes and mean estimated blood loss was 12\u2009mL. Mean preoperative SMA angle was 19\u00b0 and mean postoperative SMA angle was 36\u00b0. Patients reported that flank pain, abdominal pain, nausea, headaches, back pain, pelvic pain, and early satiety improved (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Ten of 12 respondents would recommend RALERVS for nutcracker syndrome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>RALERVS demonstrates an effective treatment for nutcracker syndrome. Patients reported improved symptoms at 3 months postoperatively across multiple domains. Further studies need to be conducted to assess long-term durability of the extravascular renal vein graft.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2023.0250","type":"journal-article","created":{"date-parts":[[2024,1,7]],"date-time":"2024-01-07T23:58:35Z","timestamp":1704671915000},"page":"371-376","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Patient-Reported Outcomes for Robot-Assisted Laparoscopic Extravascular Renal Vein Stent Placements for Nutcracker Syndrome"],"prefix":"10.1177","volume":"38","author":[{"given":"Jacques J.","family":"Farhi","sequence":"first","affiliation":[{"name":"Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hal D.","family":"Kominsky","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohannad A.","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Cadeddu","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,1]]},"reference":[{"issue":"5","key":"e_1_3_4_2_2","first-page":"257","article-title":"Anatomical and surgical aspects in the operative management of varicocele","volume":"54","author":"El-Sadr AR","year":"1950","unstructured":"El-Sadr AR, , Mina E. Anatomical and surgical aspects in the operative management of varicocele. Urol Cutaneous Rev, 1950; 54(5):257\u2013262.","journal-title":"Urol Cutaneous Rev"},{"issue":"5","key":"e_1_3_4_3_2","first-page":"507","article-title":"\u201cNutcracker\u201d phenomenon of the renal vein and venous pathology of the left kidney","volume":"55","author":"de Schepper A","year":"1972","unstructured":"de Schepper A. \u201cNutcracker\u201d phenomenon of the renal vein and venous pathology of the left kidney. J Belge Radiol, 1972; 55(5):507\u2013511.","journal-title":"J Belge Radiol"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2019.0084"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2010.08.044"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-020-01054-x"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2018.12.039"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2010.0001"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2014.0411"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.246075"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-017-0744-7"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2022.08.013"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.922715"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102420918554"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2006.10.040"}],"container-title":["Journal of Endourology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/end.2023.0250","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2023.0250","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2023.0250","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:15:52Z","timestamp":1777407352000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/end.2023.0250"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1089\/end.2023.0250"],"URL":"https:\/\/doi.org\/10.1089\/end.2023.0250","relation":{},"ISSN":["0892-7790","1557-900X"],"issn-type":[{"value":"0892-7790","type":"print"},{"value":"1557-900X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}