Kidney-sparing resection of concomitant renal artery and renal vein aneurysms by single-port retroperitoneoscopic surgery: a case report.

Renal artery aneurysm and renal vein aneurysm are rare vascular lesions, and their coexistence within the same kidney poses considerable diagnostic and surgical challenges. We report a 51-year-old woman presenting with recurrent left flank and back pain. Computed tomography angiography demonstrated a 2.1-cm upper-pole renal artery aneurysm arising from a terminal intrarenal arterial branch and a 3.0-cm renal vein aneurysm arising from a large intrarenal venous tributary in the mid-pole renal sinus. Nephrectomy had been recommended at another institution because of the anatomical complexity, but the patient strongly wished to preserve the affected kidney. She underwent single-port retroperitoneoscopic excision of both aneurysms, with closure of the terminal arterial stump, primary closure of the venous wall defect, and renorrhaphy. The operative time was 95 min, warm ischemia time was 20 min, and estimated blood loss was 30 mL. Histopathological examination confirmed the diagnoses. At 4 months after surgery, color Doppler ultrasonography demonstrated preserved main left renal arterial flow and intrarenal arterial perfusion without Doppler evidence of hemodynamically significant main renal artery stenosis. Dedicated renal venous Doppler assessment and differential renal function testing were not performed. This case demonstrates that single-port retroperitoneoscopic kidney-sparing excision can be performed in selected patients with concomitant intrarenal arterial and venous aneurysms.