A ONE-STAGE OPERATION FOR AN ABDOMINAL AORTIC ANEURYSM ASSOCIATED WITH A SEVERELY ATROPHIC RIGHT KIDNEY AND RENAL CELL CARCINOMA IN THE LEFT KIDNEY

A one-stage operation for an abdominal aortic aneurysm associated with a left renal cell carcinoma was performed on a 73-year-old male. The right kidney of this patient was severely atrophic and total renal function was highly impaired. Upon laparotomy, the aneurysm which was measured 8cm in maximal diameter was found to exist just below the origin of the renal arteries extending to the common iliac arteries. A localized renal cell carcinoma, 3cm in diameter, was recognized in the center of the left kidney which was compensatorily hypertrophied. The right kidney was highly atrophied. With consideration for the quality of life, the replacement of the aneurysm with Y-shaped graft and an enucleation of the renal cell carcinoma were performed at one-stage. Postoperatively, a large amount of fluid from 3000 up to 6000ml/day with a continuous infusion of diuretics was given, resulting in a successful preservation of the renal function without hemodialysis.