SURGICAL-TREATMENT OF ABDOMINAL AORTIC-ANEURYSM IN ASSOCIATION WITH HORSESHOE KIDNEY - 3 CASE-REPORTS AND A REVIEW OF TECHNIQUE

Horseshoe kidney is a rare congenital anomaly that can create various technical problems during surgery for repair of abdominal aortic aneur ysm. The diagnosis of this anomaly should be confirmed preoperatively in order to plan surgical strategy. Nowadays, in more than 90% of all cases, ultrasonography, contrast computerized tomography, urography, a nd angiography are the best instrumental methods of detecting this ano maly in association with abdominal aortic aneurysm. The transperitonea l approach assures the best exposure of the kidney, the ureters, the a neurysm, and both iliac vessels but the renal isthmus can pose a probl em in reimplanting aberrant renal arteries. When it is known preoperat ively that renal revascularization should be performed the left extrap eritoneal approach is a better choice. in any event, he coexistence oi horseshoe kidney and abdominal aortic aneurysm does not preclude the treatment of the latter in elective surgery of abdominal aortic aneury sm, the morbidity and mortality rates in the presence of horseshoe kid ney are much the same as those in the presence of normal kidneys. The best results in this kind of surgery are obtained by adapting one's su rgical technique to each anatomical variant that is encountered.