Surgical treatment of resistant hypertension after the operation of huge retroperitoneal teratoma: a case report and literature review

Objective To summarize the treatment strategies of resistant hypertension after operation of huge retroperitoneal teratoma and conduct a literature review to boost the awareness and management of pediatric renovascular hypertension. Methods The clinical data were collected for a 4-month-22-day-old child undergoing left side nephrectomy for resistant hypertension at Day 9 after operation of huge retroperitoneal teratoma. The clinical characteristics of pediatric renovascular hypertension were summarized and the experiences of diagnosis and treatment reviewed through both English and Chinese literature reports by searching the databases of Chinese Hownet (CNKI), Wanfang, Weipu, PubMed, SpringerLink and Google Scholar. Results The child had excellent postoperative recovery. The diagnosis of pediatric renovascular hypertension was pathologically confirmed. No hypertension recurred during a follow-up period of 6 months. A total of 364 cases of pediatric renovascular hypertension were retrieved. Two cases failed to respond to initial interventional therapy and underwent kidney excision. One case was not relieved. After anastomosing affected renal artery, the symptoms of hypertension gradually disappeared. During a postoperative follow-up period of 6 months to 12 years, all children were normotensive. Conclusions Pediatric renovascular hypertension is refractory to drug treatment. For different causes, treatment modalities vary. Resection of kidney should be the last resort when other treatments are ineffective. Key words: Hypertension, renal; Nephrectomy; Postoperative complications