全机器人自体肾移植术治疗肾门部复杂动脉瘤1例报告并文献复习

doi:10.19558/j.cnki.10-1020/r.2020.05.003

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摘要 目的：探讨机器人辅助腹腔镜肾脏切取、离体肾动脉瘤切除重建、机器人辅助自体肾移植技术治疗复杂性肾动脉瘤的安全性和可行性。方法：经CT血管造影三维重建确诊右肾动脉瘤1例,病变位于肾动脉主干末端分叉处,深入肾门,五支二级分支动脉均自瘤体发出。完善各项术前评估,对患者行机器人辅助腹腔镜右肾切取、右肾动脉瘤离体切除重建、机器人辅助自体肾移植术。结果：手术顺利,术后第1天血肌酐99.1 μmol/L,连续监测血肌酐值正常,于术后第7天出院。术后3个月复查,移植肾动脉管腔正常,血流动力学稳定,肾功能良好。结论：机器人辅助腹腔镜肾脏切取、离体肾动脉瘤切除重建、机器人辅助自体肾移植技术治疗肾门部复杂动脉瘤安全有效,值得进一步探索优化。

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	陈欣
	赵鉴明
	黄双
	王云鹏
	祖强
	范阳
	高宇
	郭伟
	张旭
	董隽

关键词 ：肾动脉瘤, 机器人手术, 自体肾移植, 工作台手术

Abstract：Objective： To investigate the safety and feasibility of robot-assisted laparoscopic nephrectomy with ex-vivo renal artery aneurysm （RAA） resection and reconstruction, and robot-assisted kidney autotransplantation to treat complex RAA. Methods： One patient with incidentally identified right RAA by three-dimensional computed tomographic angiography （CTA） underwent robot-assisted laparoscopic nephrectomy with ex-vivo RAA resection and reconstruction and robot-assisted kidney autotransplantation. The hilar RAA involving 5 branches was located at the bifurcation of main renal artery. Results： The operation was done successfully. The serum creatine was 99.1 μmol/L at 1st day after operation and remained normal continuously. The patient was discharged on the postoperative day 7. At follow-up of 3 months, imaging demonstrated normal caliber of the reconstructed renal artery with good hemodynamics and renal function preserved. Conclusions： This minimally invasive operation may be considered significantly as a safe and effective surgical technique to treat complex hilar RAA. Larger experiences with longer follow-up are necessary for further optimization.

Key words： renal artery aneurysms robotic surgery kidney autotransplantation bench surgery

收稿日期: 2020-03-06

ZTFLH:

R617

通讯作者: 张旭,xzhang@foxmail.com;董隽,jundong@vip.126.com

引用本文:

陈欣, 赵鉴明, 黄双, 王云鹏, 祖强, 范阳, 高宇, 郭伟, 张旭, 董隽. 全机器人自体肾移植术治疗肾门部复杂动脉瘤1例报告并文献复习[J]. 微创泌尿外科杂志, 2020, 9(5): 300-304.
CHEN Xin, ZHAO Jianming, HUANG Shuang, WANG Yunpeng, ZU Qiang, FAN Yang, GAO Yu, GUO Wei, ZHANG Xu, DONG Jun. Robot-assisted kidney autotransplantation for complex artery aneurysm of renal hilum-one case report and literature review. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(5): 300-304.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1617.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I5/300

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