Haddad M, Barral X, Boissier C, Bouilloc X, Beraud A M
Department Surgery B, Beilinson Medical Center, Petah-Tikva, Israel.
Eur J Vasc Surg. 1989 Oct;3(5):435-41. doi: 10.1016/s0950-821x(89)80052-0.
Complex renal artery lesions which formerly would have been treated by nephrectomy may now be reconstructed by extracorporeal surgery and autotransplantation. Our experience in 15 patients (17 operations) with renal artery lesions extending into its branches or confined to them is described. Two patients underwent separate operations on both sides. The indications for surgery were severe renovascular hypertension (10 cases), renal artery aneurysm, (5 cases) and deteriorating renal function (2 cases). Overall clinical results after a mean follow up of 3 years were considered excellent in 13 procedures (11 patients). Improvement in 2 patients and failure in the other 2, who ultimately underwent nephrectomy. Discussion is focussed on results, vascular indications, (namely aneurysm, stenosis, dissecting aneurysm and trauma) and surgical techniques. Preservation of functioning renal tissue should be the ultimate goal of renovascular surgery where the ex vivo technique, when indicated, will achieve favorable results in most patients.
以前需要通过肾切除术治疗的复杂肾动脉病变，现在可以通过体外手术和自体移植进行重建。本文描述了我们对15例（17次手术）肾动脉病变延伸至其分支或局限于分支的患者的经验。2例患者双侧分别接受手术。手术指征为重度肾血管性高血压（10例）、肾动脉动脉瘤（5例）和肾功能恶化（2例）。平均随访3年后，13例手术（11例患者）的总体临床结果被认为极佳。2例患者病情改善，另外2例失败，最终接受了肾切除术。讨论集中在结果、血管指征（即动脉瘤、狭窄、夹层动脉瘤和创伤）以及手术技术上。保留有功能的肾组织应是肾血管手术的最终目标，在有指征时，体外技术将在大多数患者中取得良好效果。
