title: [Abdominal aortic surgery and renal anomalies].
abstract: BACKGROUND
  Kidney anomalies present a challenge even for the most experienced vascular surgeon in the reconstruction of the aortoilliac segment. The most significant anomalies described in the surgery of the aortoilliac segment are a horse-shoe and ectopic kidney.
  
  
  OBJECTIVE
  The aim of this retrospective study was to analyze experience on 40 patients with renal anomalies, who underwent surgery of the aortoilliac segment and to determine attitudes on conventional surgical treatment.
  
  
  METHODS
  In the period from 1992 to 2009, at the Clinic for Vascular Surgery of the Clinical Centre of Belgrade we operated on 40 patients with renal anomalies and aortic disease (aneurysmatic and obstructive). The retrospective analysis involved standard epidemiological data of each patient (gender, age, risk factors for atherosclerosis, type of anomaly, type of aortic disease, presurgical parameter values of renal function), type of surgical approach (laparatomy or retroperitoneal approach), classification of the renal isthmus, reimplantation of renal arteries and perioperative morbidity and mortality.
  
  
  RESULTS
  Twenty patients were males In 30 (70%) patients we diagnosed a horse-shoe kidney and in 10(30%) ectopic kidney. In the cases of ruptured aneurysm of the abdominal aorta the diagnosis was made by ultrasound findings. Pre-surgically, renal anomalies were confirmed in all patients, except in those with a ruptured aneurysm who underwent urgent surgery. In all patients we applied medial laparatomy, except in those with a thoracoabdominal aneurysm type IV, when the retroperitonal approach was necessary. On average the patients were under follow-up for 6.2 years (from 6 months to 17 years).
  
  
  CONCLUSIONS
  Under our conditions, the so-called double clamp technique with the preservation of the kidney gave best results in the patients with renal anomalies and aortic disease.
authors.forename: Nikola
authors.initials: N
authors.lastname: Ilić
authors.forename: Marko
authors.initials: M
authors.lastname: Dragaš
authors.forename: Igor
authors.initials: I
authors.lastname: Končar
authors.forename: Nenad
authors.initials: N
authors.lastname: Jakovljević
authors.forename: Igor
authors.initials: I
authors.lastname: Banzić
authors.forename: Miroslav
authors.initials: M
authors.lastname: Marković
authors.forename: Lazar
authors.initials: L
authors.lastname: Davidović
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D007668:Kidney / Q000002:abnormalities*; D008297:Male; D012077:Renal Artery / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000379:methods