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存在副肾动脉时输尿管及肾盂的解剖与发育异常:尸体研究

Anatomical and Developmental Abnormalities of Ureters and Renal Pelvis Existing with Accessory Renal Arteries: Cadaveric Study.

作者信息

Chakravarthi Kosuri Kalyan, Reghunadhan Deepthynadh

机构信息

Department of Anatomy, Manipal University College Malaysia, Malacca, Malaysia.

出版信息

Ann Afr Med. 2024 Oct 1;23(4):697-703. doi: 10.4103/aam.aam_89_24. Epub 2024 Sep 14.

Abstract

BACKGROUND

Anatomical and developmental variations of ureters and renal pelvis have been observed frequently during routine human cadaveric dissection and surgical practice; however, their coexistence with accessory or aberrant renal arteries is exceptionally rare. Accordingly, this study was designed to evaluate the prevalence of anatomical and developmental abnormalities of ureters and renal pelvis existing with accessory renal arteries in human cadavers.

MATERIALS AND METHODS

This study was carried out on 50 human cadavers including dissected specimens (25 males and 25 females) the kidneys, renal pelvis, and ureters along with their arteries were exposed and the anomalous abnormalities of the renal pelvis and ureters existing with accessory renal arteries were observed. Photographs of the anomalous and developmental variations were taken for proper documentation.

RESULTS

Among the 50 cadavers studied, unilateral double ureters were found in 5 cadavers (10%), rare bilateral "S-"shaped loop of ureter with quadruple uretic constrictors in the abdominal segment of the ureter was observed in one female cadaver (2%), accessory or aberrant renal arteries were found in 15 cadavers (30%), hydronephrosis involving the renal pelvis and ureters was observed in 9 cadavers (18%). Interestingly, this prevalence was higher among males (28%) compared to females (8%). Moreover, the occurrence of bilateral hydronephrosis of the kidneys, renal pelvis, and ureters was identified in a single male cadaver, representing 2% of the sample. Notably, the prevalence of double ureter, hydronephrosis accompanied by congenital double and triple accessory renal arteries was documented in nine cadavers, accounting for 18% of the cohort.

CONCLUSION

Anatomical and developmental variations of the ureters, renal pelvis, and renal vasculature, as well as their relationships to surrounding structures, hold clinical significance due to their impact on various surgical procedures, including kidney transplantation, abdominal aorta reconstruction, interventional radiology, and urologic operations. Therefore, identifying these potential developmental variations is essential for effective surgical management to preserve renal function and ensure optimal patient outcomes.

摘要

背景

在常规人体尸体解剖和外科手术实践中,输尿管和肾盂的解剖及发育变异经常被观察到;然而,它们与副肾动脉或迷走肾动脉同时存在的情况极为罕见。因此,本研究旨在评估人体尸体中输尿管和肾盂的解剖及发育异常与副肾动脉并存的发生率。

材料与方法

本研究对50具人体尸体进行,包括解剖标本(25例男性和25例女性),暴露肾脏、肾盂、输尿管及其动脉,观察与副肾动脉并存的肾盂和输尿管的异常情况。拍摄异常和发育变异的照片以进行妥善记录。

结果

在研究的50具尸体中,5具尸体(10%)发现单侧双输尿管,1具女性尸体(2%)观察到罕见的双侧输尿管“S”形袢伴输尿管腹部段四重缩窄,15具尸体(30%)发现副肾动脉或迷走肾动脉,9具尸体(18%)观察到累及肾盂和输尿管的肾积水。有趣的是,男性的这一发生率(28%)高于女性(8%)。此外,在1具男性尸体中发现双侧肾脏、肾盂和输尿管积水,占样本的2%。值得注意的是,9具尸体记录了双输尿管、伴有先天性双副肾动脉和三副肾动脉的肾积水的发生率,占队列的18%。

结论

输尿管、肾盂和肾血管系统的解剖及发育变异,以及它们与周围结构的关系,因其对包括肾移植、腹主动脉重建、介入放射学和泌尿外科手术在内的各种外科手术的影响而具有临床意义。因此,识别这些潜在的发育变异对于有效的手术管理以保留肾功能和确保最佳患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e08/11556475/1719c6031866/AAM-23-697-g001.jpg

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