Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 5-6, Pages: 311-315
https://doi.org/10.2298/SARH1106311I
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Abdominal aortic surgery and renal anomalies
Ilić Nikola (Klinika za vaskularnu i endovaskularnu hirurgiju, Klinički centar Srbije, Beograd)
Dragaš Marko (Klinika za vaskularnu i endovaskularnu hirurgiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Končar Igor (Klinika za vaskularnu i endovaskularnu hirurgiju, Klinički centar Srbije, Beograd)
Jakovljević Nenad (Klinika za vaskularnu i endovaskularnu hirurgiju, Klinički centar Srbije, Beograd)
Banzić Igor (Klinika za vaskularnu i endovaskularnu hirurgiju, Klinički centar Srbije, Beograd)
Marković Miroslav (Klinika za vaskularnu i endovaskularnu hirurgiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Davidović Lazar (Klinika za vaskularnu i endovaskularnu hirurgiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Introduction. Kidney anomalies present a challenge even for the most
experienced vascular surgeon in the reconstruction of the aortoilliac
segment. The most significant anomalies described in the surgery of the
aortoilliac segment are a horse-shoe and ectopic kidney. Objective. The aim
of this retrospective study was to analyze experience on 40 patients with
renal anomalies, who underwent surgery of the aortoilliac segment and to
determine attitudes on conventional surgical treatment. Methods. In the
period from 1992 to 2009, at the Clinic for Vascular Surgery of the Clinical
Centre of Belgrade we operated on 40 patients with renal anomalies and aortic
disease (aneurysmatic and obstructive). The retrospective analysis involved
standard epidemiological data of each patient (gender, age, risk factors for
atherosclerosis, type of anomaly, type of aortic disease, presurgical
parameter values of renal function), type of surgical approach (laparatomy or
retroperitoneal approach), classification of the renal isthmus,
reimplantation of renal arteries and perioperative morbidity and mortality.
Results. Twenty patients were males In 30 (70%) patients we diagnosed a
horse-shoe kidney and in 10 (30%) ectopic kidney. In the cases of ruptured
aneurysm of the abdominal aorta the diagnosis was made by ultrasound
findings. Pre-surgically, renal anomalies were confirmed in all patients,
except in those with a ruptured aneurysm who underwent urgent surgery. In all
patients we applied medial laparatomy, except in those with a
thoracoabdominal aneurysm type IV, when the retroperitonal approach was
necessary. On average the patients were under follow-up for 6.2 years (from 6
months to 17 years). Conclusion. Under our conditions, the so-called double
clamp technique with the preservation of the kidney gave best results in the
patients with renal anomalies and aortic disease.
Keywords: renal anomalies, ectopic kidney, horseshoe kidney
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