Chihara Shingo, Fujino Takayuki, Matsuo Hideki, Hidaka Atsuhiro
Department of Surgery, Saiseikai Futsukaichi Hospital, Chikushino, Fukuoka, Japan.
Ann Thorac Cardiovasc Surg. 2014;20 Suppl:922-5. doi: 10.5761/atcs.cr.13-00115. Epub 2014 Jan 15.
Coexistence of horseshoe kidney and abdominal aortic aneurysm (AAA) is a rare entity that presents a technical challenge to vascular surgeons. How to approach such an AAA with horseshoe kidney and whether to divide the renal isthmus remains a controversial issue. We report here the successful surgical repair of an AAA with horseshoe kidney via the transperitoneal approach with division of the renal isthmus by Harmonic Focus, which allowed easy division of the isthmus without bleeding. Harmonic Focus, a hand-held type of harmonic scalpel, was thus useful in symphysiotomy of the horseshoe kidney.
马蹄肾与腹主动脉瘤（AAA）并存是一种罕见的情况，给血管外科医生带来了技术挑战。如何处理伴有马蹄肾的这种腹主动脉瘤以及是否切断肾峡部仍是一个有争议的问题。我们在此报告通过经腹途径使用超声刀聚焦（Harmonic Focus）切断肾峡部成功手术修复一例伴有马蹄肾的腹主动脉瘤，这使得峡部易于切断且不出血。因此，超声刀聚焦这种手持式超声刀在马蹄肾的峡部分离中很有用。
