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肾移植患者的主髂动脉手术

Aortoiliac surgery in renal transplant patients.

作者信息

Lacombe M

机构信息

Consultation de Chirurgie, Hôpital Beaujon, Clichy, France.

出版信息

J Vasc Surg. 1991 May;13(5):712-8. doi: 10.1016/0741-5214(91)90358-2.

Abstract

Fifteen patients who had undergone renal transplantation 3 months to 25 years earlier were operated on for treatment of complicated aortoiliac atherosclerosis; eight had aneurysms and seven had stenotic or obstructive lesions. Except for the first patient, operated on in 1973, in whom the kidney was protected by general hypothermia, no special measure was used to protect the kidneys. A transient increase in creatinemia occurred in 11 patients during the postoperative period, whereas creatinine values remained unchanged in the other four. All patients had regained renal function identical to the + preoperative state in less than 10 days; three of them had significant improvement as a result of correction of a lesion that was impairing renal blood flow. Results obtained in this series show that protection of the transplant during aortic surgery is not necessary, provided an adequate surgical technique is used. This technique avoids the complex methods employed in the majority of previously reported cases and appears to be a safe procedure.

摘要

15例在3个月至25年前接受肾移植的患者因复杂性主髂动脉粥样硬化接受手术治疗;8例有动脉瘤,7例有狭窄或阻塞性病变。除了1973年手术的首例患者采用全身低温保护肾脏外,未采取特殊措施保护肾脏。11例患者术后出现肌酐血症短暂升高,而其他4例患者的肌酐值保持不变。所有患者在不到10天的时间内肾功能恢复到术前状态;其中3例因纠正了影响肾血流的病变而有显著改善。本系列结果表明,只要采用适当的手术技术,主动脉手术期间无需保护移植肾。该技术避免了大多数先前报道病例中采用的复杂方法,似乎是一种安全的手术。

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