Renal Veins

肾静脉
  • 文章类型: Journal Article
    背景:Marmosets,Callithrixspp,是新世界的小猴子,已成为人类实验动物模型的重要性。尽管它使用,关于其肾脏形态测量的信息,血管化,位置有限。因此,本研究将为应用研究和比较解剖学提供基础解剖学。
    方法:在高速公路上从大西洋森林生物群落中收集了50具Callithrixspp的尸体,确认并注射10%甲醛溶液.稍后,解剖标本,并记录肾脏和肾血管的测量值和形貌。女性的左肾和右肾均明显较大。
    结果:在所研究的样本中,男性平均身长为20.00±2.46厘米,女性为20.50±1.98厘米(p=0.43)。Callithrixspp的肾脏。形状对称,类似于“豆”。“它们也是浅棕色,表面光滑。在男性中,右肾最常见的位置是L1-L2水平(92%),而左肾的位置在L2和L3之间(76%)。在女性中,右肾最常见的位置是在L1-L2水平(56%),而左肾的位置在L2和L3之间(32%)(表1)。然而,在7名(28%)男性和9名(36%)女性中,肾脏处于同一水平。
    结论:在两性中,体长和肾脏长度之间存在正相关和显着的线性相关。无论两侧和性别的肾脏位置如何,右肾的位置总是比左肾靠头颅,与其他非人灵长类动物的观察结果相似。
    BACKGROUND: Marmosets, Callithrix spp, are small New World monkeys that have gained importance as an experimental animal model for human. Despite its use, information on its renal morphometry, vascularization, and location are limited. Therefore, this study will supply basic anatomy for applied studies and for comparative anatomy.
    METHODS: Fifty cadavers of Callithrix spp were collected on highways from the Atlantic Forest biome, identified and injected with a 10% formaldehyde solution. Later, the specimens were dissected and the measurements and topography of the kidneys and renal vessels were recorded. Both left and right kidneys were significantly larger in females.
    RESULTS: In the specimens studied, the average body length was 20.00 ± 2.46 cm in males and 20.50 ± 1.98 cm in females (p = .43). The kidneys of the Callithrix spp. were symmetrical in shape and resembled a \"bean.\" They were also pale brown with a smooth surface. In males, the most frequent location of the right kidney was at the L1-L2 level (92%), while the location of the left kidney was between L2 and L3 (76%). In females, the most frequent location of the right kidney was at the L1-L2 level (56%), while the location of the left kidney was between L2 and L3 (32%) (Table 1). However, in seven (28%) males and nine (36%) females, the kidneys were at the same level.
    CONCLUSIONS: In both sexes, there was a positive and significant linear correlation between body length and kidney length. Regardless of the variable location of the kidneys in both sides and in either sexe, the right kidney was always located more cranially than the left, similar to observations in other non-human primates.
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  • 文章类型: Case Reports
    错位是与外周中心静脉导管(PICC)相关的相对罕见的并发症,特别是在股浅静脉(SFV)导管插入的情况下。据我们所知,我们是第一个报告这种罕见的情况下,在对侧肾静脉SFVPICC错位。
    一名82岁的妇女在超声引导下接受了用于PICC的SFV床边插管。随后的射线照相检查发现了意外的错位,导管尖端朝向对侧肾静脉。根据X射线检查结果拔出导管后,观察到导管保留了其功能。
    虽然罕见,在SFVPICC放置时应考虑尖端错位。迅速校正尖端位置对于防止导管故障和进一步的灾难性后果至关重要。对于接受床边SFVPICC插入的危重患者,术后X射线对提高安全性至关重要.
    UNASSIGNED: Malposition is a relatively rare complication associated with peripherally inserted central catheters (PICCs), particularly in cases of superficial femoral vein (SFV) catheterization. To the best of our knowledge, we are the first to report this rare case of SFV PICC malposition in the contralateral renal vein.
    UNASSIGNED: An 82-year-old woman underwent bedside cannulation of the SFV for PICC under ultrasound guidance. Subsequent radiographic examination revealed an unexpected misplacement, with the catheter tip positioned toward the contralateral renal vein. After pulling out the catheter on the basis of the X-ray result, it was observed that the catheter retained its function.
    UNASSIGNED: Although rare, tip misplacement should be considered in SFV PICC placement. Prompt correction of the tip position is crucial to prevent catheter malfunction and further catastrophic consequences. For critical patients receiving bedside SFV PICC insertion, postoperational X-ray is crucial for enhancing safety.
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  • 文章类型: Case Reports
    我们介绍了一名55岁的男性患者,患有右肾癌并伴有下腔静脉(IVC)长瘤栓,他接受了机器人辅助的腹腔镜根治性肾切除术,广泛的IVC切除术和左肾静脉结扎。患者仅在入院前有血尿史。我们的病例涉及切除IVC的整个腹段和左肾静脉而不进行重建。不幸的是,由于脑转移,患者在手术后一年多去世。
    We present a 55-year-old male patient with right renal carcinoma with long inferior vena cava (IVC) tumor thrombus who underwent robot-assisted laparoscopic radical nephrectomy with extensive IVC resection and left renal vein ligation. The patient had a history of hematuria only prior to admission. Our case involved resection of the entire abdominal segment of the IVC and left renal vein without reconstruction. Unfortunately, the patient passed away over a year after the surgery due to brain metastasis.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    本报告介绍了经皮肾镜取石术后肾结石静脉栓塞的血管内治疗策略,以及血管内治疗技术的多功能性,即使是泌尿外科介入术后最意外的肾血管并发症。根据PubMed的文献,科克伦,SciELO,和Science.gov存储库,这是我们首次将肾静脉结石栓塞作为经皮肾结石治疗的并发症。
    一名62岁妇女接受经皮肾镜取石术治疗左肾2.8厘米鹿角形结石。石头裂开了,在输尿管肾盂连接处留下残余碎片。腹部计算机断层扫描显示位于左主动脉后肾静脉内的0.9毫米肾外结石。使用篮式导管系统通过位于左股总静脉(CFV)中的6F45厘米鞘管捕获结石,并通过解剖进入,以通过静脉切开安全地得出结石摘除的结论。患者在血管内手术后48小时无症状出院,在利伐沙班抗凝方案下,在随访6个月前无症状或肾功能损害。
    在这种情况下提出的血管内策略对于结石抢救和静脉血流恢复是有效的。
    结论:该病例加强了血管内治疗在意外情况下的适应性。常见泌尿外科手术后可能危及生命的极为罕见的不良事件可以通过微创混合治疗来治疗。保护肾功能和维持静脉血管通畅。此报告可能会增加对管理类似事件的程序的讨论,并为文献提供解决问题的可能策略。
    UNASSIGNED: This report presents the endovascular strategies adopted to treat a kidney calculus venous embolism after percutaneous nephrolithotomy and the versatility of endovascular techniques to manage even the most unexpected renovascular complications after urological intervention. According to the literature available in PubMed, Cochrane, SciELO, and Science.gov repositories, this is the first case to our knowledge of renal vein calculus embolism as a complication of percutaneous treatment of kidney stones.
    UNASSIGNED: A 62-year-old woman underwent percutaneous nephrolithotomy to treat a left kidney 2.8-cm staghorn calculi. The stone cracked, leaving a residual fragment in the ureteropelvic junction. Abdominal computed tomography revealed a 0.9-mm extrarenal calculus located inside the left retroaortic renal vein. Calculus was captured using a basket catheter system through a 6F 45-cm sheath positioned in the left common femoral vein (CFV) and accessed by dissection to safely conclude the calculus extraction by venous cut down. The patient was asymptomatically discharged 48 hours after the endovascular procedure, under a rivaroxaban anticoagulation regimen, with no symptoms or renal function impairment until the 6 months of follow-up.
    UNASSIGNED: The endovascular strategy proposed in this case was effective for calculus rescue and venous flow restoration.
    CONCLUSIONS: This case reinforces the adaptability of endovascular therapy in an unexpected scenario. A potentially life-threatening extremely rare adverse event following a common urological procedure could be treated with minimally invasive hybrid treatment, preserving renal function and maintaining venous vascular patency. This report may add a discussion of procedures to manage similar events and bring to the literature a possible strategy to solve the problem.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:这项研究介绍并比较了一种新的腹膜内腹腔镜主动脉旁淋巴结切除术方法,以达到肾静脉的水平,“帐篷俯仰”顺行法与逆行法在妇科恶性肿瘤手术中的成功率方面,并发症发生率,以及切除的淋巴结数目.它侧重于可行性,安全,和有效性。同时,本文报道了在主动脉旁区域发现的血管解剖变异,以提高手术安全性。
    方法:这是一项回顾性队列研究,包括2020年1月至2023年12月在单中心接受腹腔镜主动脉旁淋巴结切除术治疗高危子宫内膜癌和早期卵巢癌的患者。检查患者图表的操作方式,围手术期并发症,操作细节,和组织病理学。根据手术方式分为顺行组和逆行组。根据肾静脉水平淋巴结清除成功率进一步比较两组,围手术期并发症,以及切除的淋巴结数目.定量数据采用t检验进行分析,使用秩和检验的非正态分布数据,和分类数据使用Fisher精确检验和卡方检验,统计学意义定义为P<0.05。
    结果:在173名患者中,顺行组手术成功率较高(97.5%vs68.82%),更多的淋巴结切除(中位数14vs7),减少中位失血。顺行组手术时间较短。顺行组术后并发症如淋巴囊肿和静脉血栓形成较低。28.9%的患者发现血管异常,以副腰静脉路径异常和副肾动脉最常见。
    结论:顺行方法是可行的,安全,而且有效,改善手术暴露,在没有额外器械或穿刺部位的情况下降低难度,并将器官损伤风险降至最低。与逆行方法相比,它可以有效地更好地进入肾静脉并去除更多的主动脉旁淋巴结。认识到并认真管理主动脉旁区域的各种血管异常,包括肾动脉的变异,静脉,和下腔静脉,对于减少术中出血和转换为开放手术的可能性至关重要。
    BACKGROUND: This study introduces and compares a new intraperitoneal laparoscopic para-aortic lymphadenectomy method to reach the level of the renal vein, the \"tent-pitching\" antegrade approach with the retrograde approach in gynecological malignancy surgeries in terms of success rate, complication incidence, and the number of lymph nodes removed. It focuses on the feasibility, safety, and effectiveness. Meanwhile, this article reports on the vascular anatomical variations discovered in the para-aortic region to enhance surgical safety.
    METHODS: This was a retrospective cohort study including patients undergone laparoscopic para-aortic lymphadenectomy at a single center from January 2020 to December 2023 for high-risk endometrial and early-stage ovarian cancer. Patient charts were reviewed for mode of operation, perioperative complications, operative details, and histopathology. The patients were divided into anterograde group and retrograde group according to the operation mode. The two groups were further compared based on the success rate of lymph node clearance at the renal vein level, perioperative complications, and the number of removed lymph nodes. Quantitative data were analyzed using the t-test, non-normally distributed data using the rank-sum test, and categorical data using Fisher\'s exact test and the chi-square test, with statistical significance defined as P < 0.05.
    RESULTS: Among 173 patients, the antegrade group showed higher surgery success (97.5% vs 68.82%), more lymph nodes removed (median 14 vs 7), and less median blood loss. The operation time was shorter in the antegrade group. Postoperative complications like lymphocele and venous thrombosis were lower in the antegrade group. Vascular abnormalities were found in 28.9% of patients, with accessory lumbar vein routing anomaly and accessory renal arteries being most common.
    CONCLUSIONS: The antegrade approach is feasible, safe, and effective, improving surgical exposure, reducing difficulty without additional instruments or puncture sites, and minimizing organ damage risk. It is effective in achieving better access to the renal vein and removing more para-aortic lymph nodes than the retrograde method. Recognizing and carefully managing the diverse vascular abnormalities in the para-aortic area, including variations in renal arteries, veins, and the inferior vena cava, is essential to reduce intraoperative bleeding and the likelihood of converting to open surgery.
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  • 文章类型: Journal Article
    背景:短收获右肾静脉(RV)在活体供肾移植(KT)中很常见。这种技术难题可能会干扰植入并增加热缺血时间。已经应用了克服这个问题的几种技术,包括髂静脉转位,倒置移植,合成接枝,隐静脉...伴随性腺静脉(GV)的应用,这很容易接近,耗时少,最近出版了。本研究旨在评估其有效性和安全性。
    方法:于2019年4月至2022年4月在VietDuc大学医院对使用性腺静脉延长右肾短静脉的KT进行回顾性研究。收集了以下数据:基线特征,CT扫描/肾切除术后和重建后的血管成像(mm),重建和手术时间,住院天数。结果由移植后的肾功能决定(血浆肌酐,肌酐清除率)和相关并发症。
    结果:收集了25例从活体供体获得右肾短RV的病例,并通过随附的GV进行了重建和延长。RV的附加长度为15.9±2.4mm。平均冷缺血时间,静脉成形术时间,热缺血时间分别为60.4±8.2、21.2±5.3和38.1±5.6分钟,分别。平均住院时间为15.3±3.2天。平均随访时间31±5.2个月,1年后肌酐清除率约为60毫升/分钟,未观察到血管或泌尿系统并发症。
    结论:伴随来自活体供体的GV延长KT的短右心室是可行的,安全,和有效的技术。
    BACKGROUND: Short harvested right renal veins (RV) are quite common in living donor kidney transplantation (KT). This technical difficulty might interfere implanting and increase warm ischemic time. Several techniques to overcome this problem have been applied, including iliac vein transposition, inverted transplant, synthetic graft, saphenous vein… Application of accompanying gonadal vein (GV), which is easily approachable and less time-consuming, has been recently published. This study aims to evaluate its effectiveness and safety.
    METHODS: Retrospective study on KT using the gonadal vein to lengthen the short right renal vein at Viet Duc University Hospital from April 2019 to April 2022. The following data were gathered: baseline characteristics, vascular imaging in CT scan/after nephrectomy and after reconstruction (mm), reconstruction and surgical time, hospitalization days. The outcomes were determined by kidney function after transplantation (plasma creatinine, creatinine clearance) and related complications.
    RESULTS: Twenty-five cases with procured right kidney with short RV from the living donor which were reconstructed and lengthened by the accompanying GV were collected. The additional length of RV was 15.9 ± 2.4 mm. Average cold ischemic time, venoplasty time, warm ischemic time were 60.4 ± 8.2, 21.2 ± 5.3, and 38.1 ± 5.6 min, respectively. The average hospital stay was 15.3 ± 3.2 days. Average follow-up time was 31 ± 5.2 months, creatinine clearance was around 60 ml/min after 1 year, no vascular or urologic complications was observed.
    CONCLUSIONS: Accompanying GV from a living donor to lengthen short right RV in KT is a feasible, safe, and effective technique.
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  • 文章类型: Case Reports
    对于有症状和低生育能力的男性,经皮睾丸精索静脉曲张栓塞术通常比性腺静脉手术结扎更可取,因为其微创方法和并发症发生率降低。胶水,线圈,血管塞,球囊和硬化剂以各种组合使用以实现足够的静脉闭塞。这里,我们报告了第一例已知的硬化剂材料迁移超出了用于治疗精索静脉曲张的栓塞线圈的位置,导致左肾静脉血栓.一名20多岁的男子在无并发症的左精索静脉曲张栓塞伴急性左侧腹痛2天后被送往急诊科,在CT上发现硬化剂物质导致同侧非闭塞性左肾静脉血栓并向下腔静脉延伸。他接受了3个月的抗凝治疗,3个月时的随访影像学显示该血栓消退,无肾功能损害。
    Percutaneous testicular varicocele embolisation for symptomatic and subfertile males is often preferred over surgical ligation of the gonadal vein due to its minimally invasive approach and reduced complication rate. Glues, coils, vascular plugs, balloons and sclerosants are used in various combinations to achieve sufficient venous occlusion. Here, we report on the first known case of sclerosant material migration beyond the placement of an embolisation coil for treatment of a varicocele, resulting in a left renal vein thrombus. A man in his 20s presented to the emergency department 2 days following uncomplicated left varicocele embolisation with acute left-sided abdominal pain, found to have sclerosant material causing an ipsilateral non-occlusive left renal vein thrombus with extension towards his inferior vena cava on CT. He was treated with 3 months of anticoagulation and follow-up imaging at 3 months showed resolution of this thrombus without renal impairment.
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    文章类型: Case Reports
    在一名60岁的女性的计算机断层扫描(CT)检查中偶然发现了奇静脉的孤立缺失。可以使用光子计数探测器CT在低keV的0.4mm切片厚度的高分辨率图像上评估确切的异常。奇人静脉,包括怪人拱门,缺席,轻度扩张的半奇静脉通过左肋间上静脉流向左头臂静脉。半奇静脉在第一腰椎水平连接左肾静脉。该患者是第二位使用体积绘制图像进行评估的患者。高分辨率最大强度投影图像可用于评估解剖结构。与常规CT相比,辐射剂量降低。
    The isolated absence of the azygos vein was incidentally found on computed tomography (CT) examination in a 60-year-old female. The exact anomaly can be evaluated on high-resolution images of 0.4-mm slice thickness with low keV using photon-counting detector CT. The azygos vein, including the azygos arch, was absent, and a mildly dilated hemiazygos vein flowed to the left brachiocephalic vein through the left superior intercostal vein. A hemiazygos vein connected the left renal vein at the level of the first lumbar vertebra. This patient was the second patient to undergo evaluation using volume rendering images. High-resolution maximum-intensity projection images were useful for assessing the anatomy. Radiation dose was decreased compared with that in conventional CT.
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