(NDP12) Case report – surgical repair of complex renal artery aneurysm by bench surgery and autotransplantation
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  • 2015-11-29,
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病例報告-以體外修補及自體腎臟移植作為複雜性腎動脈瘤患者之手術治療
陳鴻毅、陳文祥、林承家、黃賢祥、林政鋒、吳俊德
基隆長庚醫院 外科部 泌尿科
Case report – surgical repair of complex renal artery aneurysm by bench surgery and autotransplantation
Hung-Yi Chen, Wen-Hsiang Chen, Cheng-chia Lin, Shian-Shiang Huang, Cheng-Feng Lin, Chun-Te Wu
 Divisions of Urology, Department of Surgery, Chang Gung Memorial Hospital, Keelung
 
Case report:
  A 58-year-old woman has underlying disease of hypertension under medication control, who had incidentally found of left renal artery aneurysm (RAA) via chest computed tomography(CT) because of one episode of sudden onset chest pain. The aneurysm measured 1.5cm in diameter with some mural thrombus in the left distal main renal artery, bifurcation level. Interval enlargement about 0.4cm in diameter was noted between six-month period. Endovascular intervention was not feasible because of complex RAA pattern. She hospitalized and received hand-assisted laparoscopic nephrectomy, ex-vivo repair of the RAA and autotranplantation into the left iliac fossa. The following pathological report disclosed arteriosclerosis. Her postoperative course was smooth and uncomplicated and she tolerated the procedure well.
Conclusion:
  Endovascular surgery or in vivo aneurysm resection with angioplasty reconstruction maybe a surgical challenge for complex RAA sometimes, kidney sparing is also taken into consideration.   We here reported a case of complex RAA received hand-assisted laparoscopic nephrectomy combined with backbench ex vivo repair, followed by autotransplantation, which is a feasible and safe procedure and combines the advantage of minimally invasive surgery with the effectiveness of ex vivo aneurysm repair.
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    2015-11-29 16:44:00
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