A Novel Approach for Repairing Superior Mesenteric Artery Injury During Left Nephrectomy—6-year Follow-up

Abstract

To describe a novel approach for reconstructing the superior mesenteric artery (SMA) during left nephrectomy and review the literature. The patient was a 57-year-old man with left back pain from an unknown cause for more than 3 hours. A computed tomography scan showed a 12-×15-cm firm mass and a subcapsular hematoma in the left kidney. It was considered to be bleeding and rupture of the solid renal mass, and because of persistent pain and no documented distant metastatic disease, a transperitoneal laparoscopic nephrectomy was elected, but the procedure was converted to open surgery for SMA injury. We reconstructed the SMA with end-to-end anastomosis between the SMA and the left renal artery stump. At the 6-year follow-up, the patient had no intestine-related sequelae. Our novel approach of an end-to-end anastomosis between the SMA and the left renal artery stump is an option for SMA injury, especially when orthotopic anastomosis or repair of the SMA is not indicated.