Hu Dongliang, Zhu Dan, Zhang Yingao, Wang Xinghuan
Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Endocrinology, The Third Clinical Medical College of China Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, China.
J Minim Access Surg. 2021 Apr-Jun;17(2):175-179. doi: 10.4103/jmas.JMAS_31_20.
Adrenal vein plays an important role in performing laparoscopic adrenalectomy successfully. However, it often presents with a multitude of venous anatomical variants. Hence, having a thorough knowledge on the variant types is crucial to reduce operative complications. This study aims to present our experience in identifying adrenal vein variation in adrenalectomy through modified retroperitoneal approach.
A total of 187 patients underwent modified retroperitoneoscopic adrenalectomy between July 2017 and February 2019. Perioperative data and adrenal vein variants were recorded and analysed.
Variant adrenal veins were encountered in seven patients. On the right side, two cases were drained by two adrenal veins; one case had a common trunk of adrenal vein and an accessory hepatic vein and one case had an adrenal vein joined with the opening of the right renal vein. On the left side, two cases of anatomic variations were described as follows: one vein converged with the left inferior phrenic vein and joined with the left renal vein, whereas the other vein directly joined with the left renal vein. One case had two adrenal veins that joined with the left renal vein.
Accurate identification and proper handling of the anatomical variation in the drainage of adrenal vein are crucial to safe LA. It is helpful to anticipate and avoid bleeding, especially in large adrenal tumours.
肾上腺静脉在成功实施腹腔镜肾上腺切除术方面起着重要作用。然而，它常常存在多种静脉解剖变异。因此，全面了解变异类型对于减少手术并发症至关重要。本研究旨在介绍我们通过改良后腹腔镜入路在肾上腺切除术中识别肾上腺静脉变异的经验。
2017年7月至2019年2月期间，共有187例患者接受了改良后腹腔镜肾上腺切除术。记录并分析围手术期数据及肾上腺静脉变异情况。
7例患者出现肾上腺静脉变异。右侧，2例由两条肾上腺静脉引流；1例肾上腺静脉与副肝静脉有共同主干，1例肾上腺静脉与右肾静脉开口相连。左侧，2例解剖变异情况如下：1条静脉与左膈下静脉汇合后汇入左肾静脉，另1条静脉直接汇入左肾静脉。1例有两条肾上腺静脉汇入左肾静脉。
准确识别并妥善处理肾上腺静脉引流的解剖变异对于安全的腹腔镜肾上腺切除术至关重要。这有助于预测并避免出血，尤其是在巨大肾上腺肿瘤手术中。
