自体肾移植术治疗患儿复杂肾动脉瘤1例  

Renal autotransplantation for the treatment of complex renal aneurysm in a child:A case report

作　　者：余磊 杨文博[1] 杨宇帆 王强[1] YU Lei;YANG Wenbo;YANG Yufan;WANG Qiang(Department of Urology,Peking University People’s Hospital,Institute of Applied Lithotripsy Technology,Peking University,Beijing 100044,China;School of Nursing,Peking University,Beijing 100191,China)

机构地区：[1]北京大学人民医院泌尿外科,北京大学应用碎石技术研究所,北京100044 [2]北京大学护理学院,北京100191

出　　处：《北京大学学报(医学版)》2025年第2期396-399,共4页Journal of Peking University:Health Sciences

摘　　要：自体肾移植术(renal autotransplantation,RA)对于无法通过腔内介入治疗的一些复杂的肾血管性疾病(如复杂性肾动脉瘤、肾动脉畸形等)具有明显的技术优势[1]。对特殊类型的肾复杂血管疾病的血管重建,北京大学人民医院泌尿外科团队利用自体大隐静脉逆转替代肾动脉或肾静脉完成自体肾移植术获得了很好的临床效果,积累了一些临床经验[2]。Renal autotransplantation(RA)offers significant technical advantages for the management of certain complex renal vascular diseases,such as complex renal aneurysms and renal artery malformations.This report describes a case of a 5-year-old child with a complex left renal artery aneurysm combined with multiple aneurysms.The child was admitted to Peking University People's Hospital in December 2023 due to a one-year history of intermittent abdominal pain,with an abdominal mass detected in the past month.Computed tomography angiography(CTA)revealed multiple vascular anomalies,including:(1)a left renal artery aneurysm,(2)an abdominal aortic aneurysm,and(3)a right iliac artery aneurysm.After a comprehensive evaluation of these findings,the surgical team developed a treatment plan that involved the excision of the left renal artery aneurysm,autotransplantation of the left kidney,and resection of the abdominal aortic aneurysm with an artificial vascular catheterization.During surgery,it was discovered that the left renal artery anatomy was highly complex.The artery had two primary branches,along with an additional polar artery located at the lower pole.The aneurysm was identified at the distal end of the renal artery trunk,with a pronounced bulging at the intersection between the main renal artery trunk and its secondary branches.Due to these structural complexities,the team decided to use an ex vivo surgical approach to repair the aneurysm.Ex vivo repair involves temporarily removing the kidney from the body to repair the renal artery aneurysm with enhanced precision,enabling the surgical team to meticulously reconstruct the complex vascular architecture without the constraints of in vivo manipulation.The ex vivo repair of the renal artery aneurysm was successful,allowing for accurate vascular reconstruction and avoiding potential intraoperative complications.Following the reconstruction,the kidney was autotransplanted back into the child’s body,and blood flow was effectively restored to the organ.The therapeutic outc

关 键 词：自体肾移植 肾动脉 腹主动脉瘤 复杂肾动脉瘤 离体手术 

分 类 号：R726.9[医药卫生—儿科]