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Extracorporeal renal surgery

J L Terpstra, R van Schilfgaarde, J Zwartendijk

    The Netherlands Journal of Surgery
    |October 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Extracorporeal renal surgery, utilizing techniques from kidney transplants, offers surgical solutions for complex renal artery and kidney conditions. This approach successfully treated renovascular hypertension in most patients, with significant improvements in blood pressure control.

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    Area of Science:

    • Urology
    • Vascular Surgery
    • Nephrology

    Background:

    • Renal artery and kidney pathologies historically presented limited surgical options.
    • Advancements in renal transplant surgery have enabled new therapeutic approaches.

    Purpose of the Study:

    • To describe "extracorporeal renal surgery," a technique involving nephrectomy, workbench surgery, and kidney reimplantation.
    • To evaluate the efficacy and safety of this surgical approach for various renal conditions.

    Main Methods:

    • Surgical technique involves nephrectomy, ex vivo renal artery reconstruction (workbench surgery), and kidney reimplantation.
    • Applied to 27 extracorporeal vascular reconstructions in 25 patients with fibromuscular dysplasia causing renovascular hypertension.
    • Also applied to patients with renal carcinoma in a solitary kidney and aortic aneurysm involving renal arteries.

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    Main Results:

    • Successful reconstruction and reimplantation in 25 of 27 cases.
    • One perioperative death due to complications.
    • In the remaining 22 patients with renovascular hypertension, 100% achieved normal blood pressure at 4.5 years follow-up, with 16 cured and 6 improved.
    • Successful outcomes in patients with renal carcinoma and aortic aneurysm.

    Conclusions:

    • Extracorporeal renal surgery is a viable and effective treatment for complex renal artery diseases, including fibromuscular dysplasia.
    • This technique offers a successful alternative for managing renovascular hypertension and other challenging renal pathologies, with excellent long-term results.