Objective:To summarize the experiences in diagnosis and treatment of the complicated renal artery aneurysm (RAA).
Methods:The treatment process and result of one male patient with complicated RAA who underwent retroperitoneal laparoscopic nephrectomy, ex-vivo aneurysmectomy, renal revascularization and minimally invasive heterotopic renal autotransplantation were record, and some related literatures were reviewed.  In a 27 year old male patient, the preoperative color Doppler ultrasonograph, CT and CTA showed an aneurysm (4.5 cm×4.0 cm ×3.0 cm) located in the main renal artery bifurcation and the six branches of the right kidney. After a successful retroperitoneal laparoscopic nephrectomy, the isolated kidney was perfused with 4 ℃ renal irrigating solution immediately to protect the kidney. Then, ex-vivo aneurysm resection and renal artery revascularization with autologous great saphenous vein were performed. Finally, with minimally invasive procedure, the reconstructed right kidney was re-implanted into the right iliac fossa via the original incision for removal of the kidney.
Results:The operative procedure was completed successfully in 6.5 hours, with renal warm ischemia time of 4 min and cold ischemia time of 2.5 hours, and blood loss of 50 mL. The patient recovered without perioperative complications. The postoperative renal function was normal, and CTA at 1 month and color Doppler ultrasonograph at 2 weeks and 3 months after operation showed that the shape of the heterotransplanted kidney was normal, the blood circulation in the transplanted renal artery and vein and its branches were patent, and there was no stenosis of the ureter.
Conclusions:The procedures of retroperitoneal laparoscopic nephrectomy, ex-vivo aneurysmectomy, renal revascularization and minimally invasive heterotopic renal autotransplantation for treating complicated RAA are safe, effective, feasible and minimally invasive.