Zomorrodi Afshar, Kakaei Farzad, Zomorrodi Sahar, Bagheri Amin
Department of Urology and Kidney Transplantation, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Surgery, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Int J Nephrol Renovasc Dis. 2017 Jul 10;10:191-193. doi: 10.2147/IJNRD.S127172. eCollection 2017.
Three modalities for treating chronic kidney failure are peritoneal dialysis, hemodialysis, and kidney transplantation. Among them kidney transplantation is cost-efficient and leads to a somewhat normal quality of life. In this approach, most often the external iliac artery is selected for anastomosis, but this could be disastrous if anastomosis leads to a complication. The traditional end-to-end approach for anastomosis of the kidney artery to the internal iliac artery leads to pelvic organ ischemia. However, if the end-to-end anastomosis is replaced by an end-to-side approach, it is safer. This report discusses some cases of end-to-side anastomosis using the internal iliac artery.
In ten cases of chronic kidney failure, we anastomosed the kidney artery to the internal iliac artery with an end-to-side approach.
After vessels were unclamped, all patients had diuresis. Their creatinine was in normal range and was blood flow in the internal iliac artery, based on color Doppler ultrasound.
End-to-side anastomosis can be done in some chronic kidney failure patients if their internal iliac arteries are large enough. This approach is safer than anastomosis using the external iliac artery.
治疗慢性肾衰竭的三种方式为腹膜透析、血液透析和肾移植。其中，肾移植性价比高，能使患者生活质量接近正常水平。在这种治疗方法中，通常选择髂外动脉进行吻合，但如果吻合引发并发症则可能带来灾难性后果。传统的肾动脉与髂内动脉端端吻合方法会导致盆腔器官缺血。然而，若将端端吻合改为端侧吻合则更为安全。本报告探讨了一些使用髂内动脉进行端侧吻合的病例。
在10例慢性肾衰竭患者中，我们采用端侧吻合方法将肾动脉与髂内动脉进行吻合。
血管夹松开后，所有患者均出现利尿。根据彩色多普勒超声检查，他们的肌酐水平在正常范围内，且髂内动脉有血流。
对于部分髂内动脉足够粗大的慢性肾衰竭患者，可以进行端侧吻合。这种方法比使用髂外动脉进行吻合更安全。
