An: 2014, Nr.4, Articol Nr. 5
THE RELATION BETWEEN RENAL ARTERY VARIATIONS AND PARTIAL NEPHRECTOMY
Ileana Giuvărăşteanu, Claudia Stoica - „Carol Davila” University of Medicine and Pharmacy, Bucharest, Faculty of Medicine, Clinical Anatomy and Surgical Techniques Division, Department of Anatomy
N. Bacalbaşa - Cantacuzino Clinical Hospital, Department of Obstetrics and Gynecology
THE RELATION BETWEEN RENAL ARTERY VARIATIONS AND PARTIAL NEPHRECTOMY (Abstract): The aim of our study was to demonstrate different types of renal artery variations which are important during partial nephrectomy, and to present the adequate surgical approach of each of these variations. The study of the 15 arterial corrosion casts, which we obtained by injecting the lumen of the renal artery with a semipolymerized metacrilic resin (Mercox),showed variations in the origin and number of the apical artery and of the lower segmental artery (terminal segmental branches of the renal artery). Partial nephrectomy entails thorough dissection of the renal hilum with correct identification and selective ligation of the segmental renal artery supplying the renal segment which will be resected. Some of the arterial variations encountered in our study (apical artery or lower segmental artery arising from the renal artery or from the aorta)facilitate upper or lower polepartialnephrectomy technique, while others(two apical arteries from the two divisions of the renal artery, lower and middle segmental artery emerging from a common stem)make the technique more difficult. Surgeons who perform partial nephrectomy must have a good knowledge of the renal artery segmentary anatomy which is highly variable, in order to minimize the risk of any vascular injury during the surgical procedure.
Key words: SEGMENTAL RENAL ARTERY, SELECTIVE LIGATION, PARTIAL NEPHRECTOMY