腹主动脉瘤合并马蹄肾的外科治疗:要点与难点

Surgical treatment of abdominal aortic aneurysm associated with horseshoe kidney: essentials and difficulties

腹主动脉瘤(AAA)合并马蹄肾(HSK)是一种罕见疾病。外科治疗需首要考虑肾脏的异常解剖,包括HSK峡部骑跨瘤体,以及起源于腹主动脉的副肾动脉等。目前的治疗方法有开放手术(经腹或腹膜后)、腔内修复术及杂交手术,但3种手术方法应用的适应证、具体处理方式尚未统一。笔者总结分析AAA合并HSK外科治疗要点与难点,以为临床实践提供参考。

Abdominal aortic aneurysm（AAA） with concomitant horseshoe kidney（HSK） is a rare clinical entity. Special consideration to the abnormal anatomy of the kidney, such as the isthmus of the HSK straddling the aneurysm and the accessory renal arteries originating from the abdominal aorta, should be taken during its surgical treatment. Current treatment methods include open surgery（transabdominal or retroperitoneal）, endovascular repair and hybrid surgery. But the indications and specific technical approach for those procedures remain inconclusive. In this paper, the authors present and analyze the essentials and difficulties in surgical treatment of this condition, so as to provide a reference for clinical practice.