肾动脉瘤的外科手术
Surgical procedures for renal artery aneurysms.
作者信息
Jibiki Masatoshi, Inoue Yoshinori, Kudo Toshifumi, Toyofuku Takahiro
机构信息
Department of Vascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
出版信息
Ann Vasc Dis. 2012;5(2):157-60. doi: 10.3400/avd.oa.11.00055.
OBJECTIVE
The aim of this study was to assess the strategy and surgical procedures for treating a renal artery aneurysm (RAA).
PATIENTS AND METHODS
We retrospectively reviewed the surgical strategy for 21 cases with RAA between 2001 and 2010 at this institution. Treatment was indicated for patients with an RAA larger than 2 cm and/or symptoms. Surgical treatment was the initial strategy, and coil embolization was indicated in the case of narrow-necked, saccular, extraparenchymal aneurysms.
RESULTS
Fifteen patients in 21 cases received an aneurysmectomy and renal artery reconstruction with an in-situ repair. One patient underwent an unplanned nephrectomy, and coil embolization was performed in 5 patients.
CONCLUSION
In-situ repair was safe and minimally invasive. RAA, even in the second bifurcation, could be exposed by a subcostal incision, and the transperitoneal approach permitted the safe treatment of an RAA with acceptable results, in our simple preservation of renal function.
目的
本研究旨在评估治疗肾动脉动脉瘤（RAA）的策略和手术方法。
患者与方法
我们回顾性分析了2001年至2010年间本机构收治的21例RAA患者的手术策略。对于RAA大于2 cm和/或有症状的患者进行治疗。手术治疗是初始策略，对于窄颈、囊状、肾实质外动脉瘤则采用弹簧圈栓塞。
结果
21例患者中有15例接受了动脉瘤切除术及肾动脉原位修复重建术。1例患者接受了非计划肾切除术，5例患者进行了弹簧圈栓塞。
结论
原位修复安全且微创。即使是在肾动脉二级分支处的RAA，经肋下切口也可暴露，经腹途径能够安全治疗RAA，在我们简单的肾功能保留方面取得了可接受的结果。
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