目的总结复杂性肾动脉瘤1例的诊治经验。方法报告采用后腹腔镜取肾、离体肾动脉瘤切除、肾动脉重建和自体肾移植治疗复杂性肾动脉瘤1例的治疗经过及结果,并复习文献。患者,男,27岁。术前彩超、CT及CTA示:动脉瘤体4.5 cm×4.0 cm×3.0 cm大小,靠近肾门,位于肾动脉主干远端分叉部,累及6根分支。采用后腹腔镜切取右肾后,离体肾脏采用4℃低温肾脏保存液灌注、离体行肾动脉瘤切除及自体大隐静脉肾动脉重建,然后通过原取肾切口将肾脏移植于右髂窝。结果手术顺利,时间为6.5 h,失血约50 mL,肾热、冷缺血时间分别为4 min和2.5 h。围手术期未出现并发症,术后肾功能正常。术后1个月CTA及2周和3个月彩超复查显示右髂窝移植形态正常,肾动脉及其分支血流通畅无狭窄,肾静脉血流通畅,输尿管无狭窄。结论后腹腔镜取肾、离体肾动脉瘤切除、肾动脉成形和自体肾移植用于治疗远段和/或累及分支的复杂性肾动脉瘤,微创、安全、有效、可行。 Objective To summarize the diagnosis and treatment of one case of complex renal aneurysm. Methods The laparoscopic removal of kidney, excision of renal artery aneurysm, reconstruction of renal artery and autologous renal transplantation for the treatment of complex renal aneurysms were reviewed. The results were reviewed and the literature reviewed. Patient, male, 27 years old. Preoperative ultrasound, CT and CTA showed: aneurysm size of 4.5 cm × 4.0 cm × 3.0 cm, close to the renal portal, located in the distal renal artery distal bifurcation, involving 6 branches. After the right kidney was cut by retroperitoneal laparoscopy, the isolated kidneys were perfused with low-temperature renal preservation solution at 4 ℃ and excised by renal artery aneurysm in vitro. The kidneys were transplanted into the right iliac fossa . Results The operation was successful, with a time of 6.5 h and a blood loss of about 50 mL. Renal fever and cold ischemia time were 4 min and 2.5 h, respectively. Perioperative complications did not occur, postoperative renal function was normal. One month after surgery, CTA and 2 weeks and 3 months ultrasound examination showed that the right iliac fossa transplantation morphology was normal, the renal artery and its branches had no constriction of blood flow, renal vein blood flow and ureteral stricture. Conclusions Laparoscopic nephrectomy, excised renal aneurysm, renal artery angioplasty and autologous renal transplantation are useful for the treatment of complicated renal aneurysms with distal and / or branch involvement. Minimally invasive, safe, effective and feasible.