Sachin S, Rajesh M C, Ramdas E K
Department of Anaesthesia, BMH, Kozhikode, Kerala, India.
Anesth Essays Res. 2016 Sep-Dec;10(3):680-683. doi: 10.4103/0259-1162.186615.
Surgical removal of the kidney tumor outside the body, ( renal bench surgery) followed by auto transplantation is an emerging and often done procedure to reconstruct the urinary tract. It possesses immense challenges to both the anesthesiologists and the surgeons. The risks are multiplied if you are performing the surgery on a solitary functioning kidney. Here, we are describing the anesthetic management of 70-year-old male post nephrectomy patient undergoing renal auto transplantation by bench surgery. Our primary goals for perioperative management were to maintain a stable hemodynamics throughout the procedure, to reduce fluid overload during the period of extracorporeal surgery, to maintain perfusion for the transplanted solitary kidney, to control bleeding to a minimum, and to provide adequate analgesia for the patient. We made use of a balanced anesthetic technique and stringent monitoring standards to bring forth a successful outcome for the patient. At the end of his hospital stay, patient went home with a healthy, normally functioning kidney.
在体外切除肾肿瘤(肾体外手术),然后进行自体移植,这是一种新兴且经常实施的重建尿路的手术。这对麻醉医生和外科医生都构成了巨大挑战。如果对单功能肾进行手术,风险会成倍增加。在此,我们描述了一名70岁男性肾切除术后患者通过体外手术进行肾自体移植的麻醉管理。我们围手术期管理的主要目标是在整个手术过程中维持稳定的血流动力学,在体外手术期间减少液体超负荷,维持移植的单功能肾的灌注,将出血控制到最低限度,并为患者提供充分的镇痛。我们采用了平衡麻醉技术和严格的监测标准,为患者带来了成功的结果。在患者住院结束时,带着一个健康、功能正常的肾脏回家了。