Lacombe M
Consultation de Chirurgie, Hôpital Beaujon, Clichy, France.
J Cardiovasc Surg (Torino). 1992 Mar-Apr;33(2):163-8.
Twenty patients were operated upon for acute obstruction of their main renal arteries (25 kidneys at risk), 18 hours to 68 days after the onset of obstruction. Three nephrectomies were necessary because of total renal infarction but revascularization was possible in all the other cases. The postoperative mortality rate was 15%; definitive kidney salvage rate was 64%. The function of the preserved kidneys was usually satisfactory. This surgical experience has led us to the following conclusions: acute obstruction of a main renal artery does not necessarily cause renal infarction as viability of the kidney can be maintained over long periods of time by the collateral circulation; neither non-function of the kidney, nor the duration of renal artery obstruction must be regarded as signs of renal infarction; no investigation can provide information as to the exact condition of the kidney before surgery. Apart from critically ill patients or segmental renal obstructions, the treatment should be surgical, irrespective of the time that has elapsed from the onset of the obstruction.
20例患者因主肾动脉急性梗阻接受手术治疗（25个肾脏面临风险），梗阻发生后18小时至68天进行手术。由于肾完全梗死，3例患者需要进行肾切除术，但其他所有病例均可行血管重建术。术后死亡率为15%；确切的肾脏挽救率为64%。保留肾脏的功能通常令人满意。这段手术经验使我们得出以下结论：主肾动脉急性梗阻不一定会导致肾梗死，因为肾脏的活力可通过侧支循环长期维持；肾脏无功能以及肾动脉梗阻的持续时间都不应被视为肾梗死的迹象；术前没有任何检查能够提供肾脏确切状况的信息。除了危重症患者或节段性肾梗阻外，无论梗阻发生后经过了多长时间，治疗均应采取手术方式。
