Anatomo-radiological mapping of the arrangement of ascending lumbar veins in relation to renal veins: is there a way to predict the risk of intraoperative lesions?
- Autores: Marcos O. Siebra Coelho, Rachel Carvalho, Gilberto R. Oliveira, Barbara Weberling, Gustavo Carvalho da Silva, Allan C. Feitosa, Ludmilla Gomes, Diogo P. Tavares, André L. Saud, João A. Pereira Correia, Valter J. Muller
- Localización: European Journal of anatomy, ISSN-e 1136-4890, Vol. 21, Nº. 3, 2017, págs. 211-217
- Idioma: inglés
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Resumen
The aim of our study was to describe the critical area for iatrogenic lesions of the lumbar veins during the intraoperative manipulation of the renal veins and propose predictive indications for identifying those veins found in potential risk for iatrogenic lesions. Adult human cadavers were dissected and contrast enhanced images of CT and MR scans were randomly selected and analyzed. The distances from the first lumbar veins to the right and left renal veins were measured, respectively. The diameter of the renal veins and of the inferior vena cava was calculated. Correlation of the distances between the first lumbar veins and the corresponding renal veins, as well as the diameter of the renal veins and the inferior vena cava was performed. We obtained 205 specimens. The average distances between the right and left first lumbar veins and their respective renal veins was 3,5cm and 3,8cm, respectively (p<0.0001). We found 40 (20%), 96 (46%) and 69 (34%) lumbar veins at high, moderate and low risk for intraoperative lesion, on the right side, respectively, and 34 (17%), 86 (42%) and 85 (41%) lumbar veins, on the left side, respectively. The correlation between the size of the renal veins and the first lumbar vein-renal vein distance found a statistically significant difference, only on the left side (p=0.02). We describe the arrangement of the lumbar veins in relation to the renal veins, proposing a way to predict the existence of a "risk zone" for inadvertent, intraoperative vascular lesions.
