Deák P Á, Doros A, Lovró Z, Toronyi E, Kovács J B, Végsö G, Piros L, Tóth S, Langer R M
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
Transplant Proc. 2011 May;43(4):1230-2. doi: 10.1016/j.transproceed.2011.03.069.
Among the several vascular variation those concerning the venous system of the kidneys show the most significant variability. They often play an important role when it comes to choosing the kidney to be removed for transplantation. Based on our prior studies, we have surveyed these variations. When performing a laparoscopic living donor nephrectomy owing to the limited field of vision and the restricted possibilities for preparation, preoperative radiologic planning is of utmost importance. We evaluated 55 donors who underwent laparoscopic nephrectomies using the 16-section multidetector-row computed tomography angiography. Among the donors who underwent surgeries we observed circumaortic veins (CAV) in three cases, retroaortic veins in 6 cases, multiple renal veins in 10 cases, and a lumbar vein draining into the left renal vein (RV) in 30 cases. In the 2 cases wherein CAVs were discovered, the team decided to use the other kidney. In 1 case, due to a short right RV, we chose the left kidney. The complex development of the CAV that is sometimes difficult to reconstruct in 3D poses a challenge for both the radiologist and the surgeon.
在多种血管变异中，涉及肾脏静脉系统的变异最为显著。在选择用于移植的供肾时，这些变异往往起着重要作用。基于我们之前的研究，我们对这些变异进行了调查。由于腹腔镜活体供肾切除术视野有限且准备工作的可能性受限，术前放射学规划至关重要。我们评估了55例行腹腔镜肾切除术的供体，采用16层多排螺旋计算机断层血管造影术。在接受手术的供体中，我们观察到3例存在环主动脉静脉（CAV），6例存在主动脉后静脉，10例存在多条肾静脉，30例存在一条腰静脉汇入左肾静脉（RV）。在发现CAV的2例中，手术团队决定使用另一侧肾脏。在1例中，由于右侧肾静脉较短，我们选择了左侧肾脏。CAV复杂的发育情况有时难以进行三维重建，这给放射科医生和外科医生都带来了挑战。
