腹腔镜手术治疗肾动脉瘤1例报告并文献复习

茅夏娃; 张大宏; 刘锋; 祁小龙; 章越龙; 张琦

腹腔镜手术治疗肾动脉瘤1例报告并文献复习

- 1 浙江省人民医院泌尿腔镜中心(杭州, 310014)

详细信息

通讯作者: 茅夏娃,E-mail:evevev96@hotmail.com

中图分类号: R737.11

收稿日期: 2011-11-16

Laparoscopic surgery for renal artery aneurysm:a case report and literature review zhejiang provincial people’s hospital endourology cencer

- Urology Laparoscope Center, Zhejiang Province People's Hospital, Hangzhou, 310014, China

More Information

Corresponding author: MAO Xiawa, E-mail: evevev96@hotmail.com

Received Date: 16 November 2011

摘要

摘要: 目的:探讨腹腔镜术治疗肾动脉瘤的可行性与方法。方法:报告1例59岁女性患者,因"反复高血压10年,检查发现肾动脉瘤1周"入院。CTA示右肾动脉瘤,直径2 cm,肾动脉主干发出两支二级动脉分支,动脉瘤位于其中一根二级分支近主干处。患者左侧卧位,建立气腹,游离肾脏及血管,分离动脉瘤体,用哈叭狗钳分别阻断主干及两根二级分支,用剪刀将动脉瘤完整切除。4-0血管缝线缝合动脉破口,2-0可吸收线缝合肾周筋膜,局部放置一引流管。结果:手术成功,手术时间125 min,其中热缺血时间28 min,血管缝合时间8 min,术中出血50 ml,患者术后24小时开始进食半流质,48小时开始下床行走。术后3天起患者血压较术前入院时170/100 mmhg明显下降,波动于124~145/70~85 mmhg。术后7天CT复查示右肾动脉未见狭窄,右肾小部分缺血表现,出院。结论:腹腔镜下肾动脉瘤切除手术可行,熟练的操作与精细的缝合是其关键。
- 肾动脉瘤 /
- 腹腔镜术 /
- 治疗
Abstract: Objective:To evaluate feasibility and method about laparoscopic treatment of renal artery aneurysm.Methods:The patient, female, 59 years old, was admitted for "repeated hypertension for 10 years, examination revealed renal artery aneurysm for 1 week". CTA showed:right renal artery aneurysm, 2cm with diameter. The renal artery issued two branch arteries and the aneurysm is located near the trunk of one of the two branch. Surgical methods:patients with left lateral position, routine disinfection and draping, establishment of pneumoperitoneum, dissection of kidney, blood vessels, tumor body respectively. To block the main artery and two branches with lap dogs, complete aneurysm resection with scissors, suturing the artery with 4-0 vascular suture, perirenal fascia with 2-0 absorbable suture, place one drainage tube in local place.Results:The operation was successful with the operation time 125 min, warm ischemia time 28 min, vascular closure time 8 min. Blood loss was 50 ml. The patients began to eat semi-liquid 24 hours after the surgery, walking out of bed after 48 hours, discharged after 7 days. 7 days later, CT scans showed:no right renal artery stenosis, a small part of the ischemic kidney performance.Conclusions:Laparoscopic renal artery aneurysm resection is feasible, with the key skilled performing and fine suture.
- renal artery aneurysm /
- laparoscopy /
- treatment

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参考文献(9)

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