Natsis Konstantinos, Tsitouridis Ioannis, Totlis Trifon, Levva Sofia, Tsikaras Prokopios, Skandalakis Panagiotis
Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Greece.
Am Surg. 2008 Dec;74(12):1190-4.
In the present study, we propose a classification of the different forms of the circumaortic renal collar based on the findings of 319 patients and on a literature review. The patients underwent a CT angiography scan of the abdomen for various diagnostic reasons. The different forms in which the circumaortic renal collar may appear were categorized. The renal collar was observed in eight of the 319 (2.5%) patients. The classification we propose is the following: Type I, one left renal vein splitting into two branches, a preaortic and a retroaortic, draining into the inferior vena cava; Type II, two different left renal veins, the one preaortic and the other retroaortic, draining into the inferior vena cava; and Type III, either anastomoses between the preaortic and retroaortic vein, being multiple or not, or multiple preaortic or retroaortic renal veins without anastomoses. Although the circumaortic renal collar is usually asymptomatic, the knowledge of this variation is useful, mainly before abdominal aortic aneurysm surgery and renal transplantation. Failure to recognize the collar's retroaortic component may lead to hemorrhage and death during retroperitoneal surgery. We believe that our classification contributes to recognize the circumaortic renal collar's morphology both preoperatively and intraoperatively.
在本研究中，我们基于319例患者的检查结果及文献综述，对围绕主动脉的肾静脉环的不同形态进行了分类。这些患者因各种诊断原因接受了腹部CT血管造影扫描。对围绕主动脉的肾静脉环可能出现的不同形态进行了分类。在319例患者中有8例（2.5%）观察到肾静脉环。我们提出的分类如下：I型，一条左肾静脉分成两个分支，一个位于主动脉前，另一个位于主动脉后，汇入下腔静脉；II型，两条不同的左肾静脉，一条位于主动脉前，另一条位于主动脉后，汇入下腔静脉；III型，主动脉前静脉与主动脉后静脉之间存在多处或非多处吻合，或存在多条无吻合的主动脉前或主动脉后肾静脉。尽管围绕主动脉的肾静脉环通常无症状，但了解这种变异是有用的，主要是在腹主动脉瘤手术和肾移植之前。未能识别肾静脉环的主动脉后部分可能导致腹膜后手术期间出血和死亡。我们认为我们的分类有助于在术前和术中识别围绕主动脉的肾静脉环的形态。
