Yucel Tayfun, Ekiz Feza, Gurdal Sibel Ozkan, Yavuz Hasan, Gonullu Dogan, Koksoy Ferda Nihat, Sit Mustafa, Igdem Aysenur Akyildiz, Sahan Elife
Sakarya University, Sakarya Medical School, Department of Surgery, Sakarya, Turkey.
Int J Surg. 2009 Aug;7(4):350-5. doi: 10.1016/j.ijsu.2009.05.006. Epub 2009 May 27.
In cases of trauma to the left renal vein (LRV), its ligation near the inferior vena cava (IVC) is considered, but the consequences are not always good. We investigated the role of collateral venous drainage after ligation of the LRV by studying the renal function and histology after ligation of the LRV near the IVC alone or with ligation of the gonadal or adrenal collaterals, in right-nephrectomized (RN) rats.
Ligation of the LRV near the IVC alone (group 1) or with ligation of the adrenal (group 2) or gonadal (group 3) collaterals was studied in RN Wistar rats (n=18 per group). The renal histopathology (ischemic cortical necrosis) and functional status (urea, creatinine, sodium, and potassium) were compared.
In RN rats, the results were better when ligating the LRV near the IVC alone or with the adrenal collaterals [mortality 4/18 (22.2%) and 3/18 (16.7%), respectively] than when ligating the LRV near the IVC plus the gonadal collaterals [mortality 15/18 (83.3%)] (p<0.0001). All early deaths occurred within three days and resulted from serious histopathological (ischemic cortical necrosis) and functional (increased urea, creatinine, and potassium; decreased sodium) renal damage.
In right-nephrectomized rats, the LRV near the IVC and the adrenal collateral can be ligated, while the gonadal collateral should be preserved.
在左肾静脉(LRV)受到创伤的情况下,会考虑在靠近下腔静脉(IVC)处对其进行结扎,但后果并非总是良好。我们通过研究在右肾切除(RN)大鼠中单独结扎IVC附近的LRV或同时结扎性腺或肾上腺侧支静脉后,侧支静脉引流在LRV结扎后的作用,来进行研究。
在RN Wistar大鼠(每组n = 18)中,研究单独结扎IVC附近的LRV(第1组)或同时结扎肾上腺(第2组)或性腺(第3组)侧支静脉的情况。比较肾脏组织病理学(缺血性皮质坏死)和功能状态(尿素、肌酐、钠和钾)。
在RN大鼠中,单独结扎IVC附近的LRV或同时结扎肾上腺侧支静脉时的结果[死亡率分别为4/18(22.2%)和3/18(16.7%)]优于结扎IVC附近的LRV加性腺侧支静脉时的结果[死亡率为15/18(83.3%)](p<0.0001)。所有早期死亡均发生在三天内,是由严重的组织病理学(缺血性皮质坏死)和功能性(尿素、肌酐和钾升高;钠降低)肾损伤所致。
在右肾切除的大鼠中,可以结扎IVC附近的LRV和肾上腺侧支静脉,而性腺侧支静脉应予以保留。