左肾切除术中肠系膜上动脉损伤的一种新方法-6 年随访。
A Novel Approach for Repairing Superior Mesenteric Artery Injury During Left Nephrectomy-6-year Follow-up.
机构信息
Department of Urology, the first hospital of Lanzhou university, Lanzhou, China.
Jinchang hospital of integrated traditional Chinese and western medicine, Jinchang, China.
出版信息
Urology. 2020 Oct;144:241-244. doi: 10.1016/j.urology.2020.07.017. Epub 2020 Jul 24.
OBJECTIVE
To describe a novel approach for reconstructing the superior mesenteric artery (SMA) during left nephrectomy and review the literature.
MATERIALS AND METHODS
The patient was a 57-year-old man with left back pain from an unknown cause for more than 3 hours. A computed tomography scan showed a 12- × 15-cm firm mass and a subcapsular hematoma in the left kidney. It was considered to be bleeding and rupture of the solid renal mass, and because of persistent pain and no documented distant metastatic disease, a transperitoneal laparoscopic nephrectomy was elected, but the procedure was converted to open surgery for SMA injury. We reconstructed the SMA with end-to-end anastomosis between the SMA and the left renal artery stump.
RESULTS
At the 6-year follow-up, the patient had no intestine-related sequelae.
CONCLUSION
Our novel approach of an end-to-end anastomosis between the SMA and the left renal artery stump is an option for SMA injury, especially when orthotopic anastomosis or repair of the SMA is not indicated.
目的
描述一种在左肾切除术中重建肠系膜上动脉（SMA）的新方法，并复习文献。
材料与方法
患者为 57 岁男性，左侧腰痛 3 小时以上，原因不明。CT 扫描显示左肾 12×15cm 实性肿块和包膜下血肿。考虑为实质性肾肿块出血和破裂，由于持续疼痛且无远处转移证据，选择经腹腔腹腔镜肾切除术，但由于 SMA 损伤，手术转为开放手术。我们采用 SMA 与左肾动脉残端端端吻合重建 SMA。
结果
在 6 年随访中，患者无肠道相关后遗症。
结论
SMA 与左肾动脉残端端端吻合是 SMA 损伤的一种选择，尤其是当不适合原位吻合或 SMA 修复时。
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