Superior mesenteric artery injury during laparoscopic radical nephrectomy

E. Kruglov, A. I. Narkevich, A. Babich, Y. Pobedintseva, V. A. Kudlachev, E. V. Filimonov, A. Goncharov, V. Unguryan
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Abstract

The authors present to your a en on a rare clinical case of complete intersec on of the superior mesenteric artery in laparoscopic radical nephrectomy. This complica on emerged in the process of learning the technique of laparoscopic radical nephrectomy, before reaching the “plateau” of the learning curve, in condi ons of poor vision and in the interposi on of tissues due to paratumorous infitiltra on. This type of injury has a high risk of total necrosis of the small intestine. However, due to the concerted ac ons of the surgical service and the readiness of surgeons to complete the vascular suture of the main vessels, a successful reimplanta on of the superior mesenteric artery into the aorta was performed. This is confi rmed by postopera ve observa on and examina on, which included CT angiography. It should be noted that descrip ons of cases of aor c reimplanta on of the superior mesenteric artery are extremely rare in the world and national literature, except for cases of mesenteric ischemia. This case contributes to the description of rare cases of aor c reimplanta on of the superior mesenteric artery and shows the correctness of the selected surgical tactics.
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腹腔镜肾根治术中肠系膜上动脉损伤
本文报告一例罕见的腹腔镜肾根治术中肠系膜上动脉完全切断的临床病例。该并发症出现在学习腹腔镜根治性肾切除术技术的过程中,在达到学习曲线的“平台”之前,在视力不佳的情况下,在肿瘤旁浸润导致组织介入的情况下。这种类型的损伤具有小肠全坏死的高风险。然而,由于外科服务的协调一致和外科医生准备完成主要血管的血管缝合,成功地将肠系膜上动脉重新植入主动脉。术后的观察和检查,包括CT血管造影证实了这一点。值得注意的是,除了肠系膜缺血的病例外,对肠系膜上动脉动脉再植的病例的描述在国际和国内文献中都是非常罕见的。本病例有助于描述罕见的肠系膜上动脉aor - c再植病例,并表明所选择的手术策略的正确性。
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