Saadallah Fatma, Ben Ltaief Sarra, Houcine Yoldez, Ben Dhiab Tarek
Surgical Oncology Department, Salah Azaiez institute, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia.
Surgical Oncology Department, Salah Azaiez institute, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia.
Int J Surg Case Rep. 2024 Dec;125:110531. doi: 10.1016/j.ijscr.2024.110531. Epub 2024 Oct 28.
The right ovarian vein typically drains into the inferior vena cava, while the left ovarian vein terminates in the left renal vein. Variations in the drainage pattern of the ovarian veins are infrequent, with reported incidences ranging from 0.03 % to 9.9 % across various studies. However, rare anatomical variations can significantly complicate surgical procedures, particularly lymphadenectomy for ovarian cancer.
We present a case of a patient in her 40s referred to Salah Azaiez Institute for ovarian cancer management. We performed ovarian staging. During the retroperitoneal lymphadenectomy, we identified an unusual anatomical variation in the drainage of the right ovarian vein.
Anatomical variations of the ovarian and renal veins, although rare, have significant clinical implications. A cadaveric study revealed that only 3 out of 94 dissected ovarian veins exhibited variations, with one draining into the inferior vena cava (0.01 %). Such variations can lead to vascular and postoperative complications, emphasizing the need for vascular surgeons, urologists, and oncologists to understand these anomalies thoroughly. Preoperative imaging using computed tomography angiography is crucial for identifying these variations before surgical interventions, thus enhancing surgical planning and clinical outcomes.
This case underscores the importance for surgeons to be aware of anatomical variations during retroperitoneal surgeries to prevent complications and ensure optimal surgical outcomes.
右侧卵巢静脉通常汇入下腔静脉，而左侧卵巢静脉则终止于左肾静脉。卵巢静脉引流模式的变异并不常见，各项研究报道的发生率在0.03%至9.9%之间。然而，罕见的解剖变异会使手术过程显著复杂化，尤其是卵巢癌的淋巴结清扫术。
我们报告一例40多岁的患者，转诊至萨拉赫·阿扎耶兹研究所接受卵巢癌治疗。我们进行了卵巢分期。在腹膜后淋巴结清扫术中，我们发现右侧卵巢静脉引流存在异常的解剖变异。
卵巢静脉和肾静脉的解剖变异虽然罕见，但具有重要的临床意义。一项尸体研究显示，在94条解剖的卵巢静脉中，只有3条表现出变异，其中1条汇入下腔静脉（0.01%）。此类变异可导致血管和术后并发症，强调血管外科医生、泌尿科医生和肿瘤学家需透彻了解这些异常情况。术前使用计算机断层血管造影成像对于在手术干预前识别这些变异至关重要，从而改善手术规划和临床结果。
该病例强调了外科医生在腹膜后手术中了解解剖变异以预防并发症并确保最佳手术结果的重要性。
