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Serena G, González J, Garcia LE, Guerra G, Morsi M, Ciancio G. Hand-assisted laparoscopic nephrectomy in a high risk overweight donor with left-sided IVC, and previous abdominal surgery. Int J Surg Case Rep 2019; 64:20-23. [PMID: 31593912 PMCID: PMC6796603 DOI: 10.1016/j.ijscr.2019.09.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/22/2019] [Accepted: 09/25/2019] [Indexed: 11/29/2022] Open
Abstract
Surgical planning based on preoperative CTA is necessary in patients with vascular anomalies in order to avoid complications. Intrabdominal adhesions are common in patients with previous abdominal surgery and can affect the surgical approach for donor nephrectomy. Considering the extension of the donor eligibility criteria, it is expected to see cases with congenital vascular anomalies.
Introduction The extension of donor eligibility criteria represents one of the possible ways to increase the organ shortage, thus decreasing the waiting time for kidney transplantation. Expectedly, this strategy is associated with a growing number of more technically demanding living donor nephrectomy procedures requiring careful assessment, and sound surgical experience in order to avoid intraoperative complications. Case presentation After a thorough evaluation through preoperative imaging, we performed a hand-assisted left laparoscopic living donor nephrectomy in a 56 year-old overweight patient with history of prior abdominal surgery, harboring a left-sided inferior vena cava (IVC). Discussion/conclusion This case describes our comprehensive approach in this complex surgical scenario to preserve donor safety and provide an optimal kidney graft.
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Affiliation(s)
- Giuseppe Serena
- Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA; Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA; Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - Javier González
- Department of Urology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Leonardo E Garcia
- Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA; Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - Giselle Guerra
- Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA; Department of Medicine, Division of Nephrology, Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - Mahmoud Morsi
- Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA; Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - Gaetano Ciancio
- Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA; Department of Urology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA; Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
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Hostiuc S, Minoiu C, Negoi I, Rusu MC, Hostiuc M. Duplication and transposition of inferior vena cava: A meta-analysis of prevalence. J Vasc Surg Venous Lymphat Disord 2019; 7:742-755. [DOI: 10.1016/j.jvsv.2019.01.063] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 01/27/2019] [Indexed: 12/26/2022]
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Iezzi R, Posa A, Carchesio F, Manfredi R. Multidetector-row CT imaging evaluation of superior and inferior vena cava normal anatomy and caval variants: Report of our cases and literature review with embryologic correlation. Phlebology 2018; 34:77-87. [DOI: 10.1177/0268355518774964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective To assess the potential of multidetector-row computed tomography imaging and its reformations in the evaluation of the superior and inferior vena cava normal anatomy and their anatomical variants, and to make a brief review of caval embryogenesis and developmental errors. Methods We retrospectively reviewed a total of 1000 whole-body computed tomography scans performed between January 2010 and December 2016 to assess the normal superior and inferior vena cava anatomy and their variants. Results The normal superior and inferior vena cava anatomy was found in 88.9% of patients, whereas multiple variants were found, ranging from the superior or inferior vena cava duplication, to the azygos continuation of the inferior vena cava. Conclusions Computed tomography is a powerful tool to analyse superior and inferior vena cava anatomical variants. The knowledge and assessment of normal caval anatomy and of its anatomical variants is mandatory in the correct pre-operative planning in surgical and radiological interventions. Knowledge of caval variants is helpful in the differential diagnosis of abdominal or mediastinal masses, to avoid misdiagnosis, as well as in the screening of associated congenital pathologic conditions.
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Affiliation(s)
- Roberto Iezzi
- Department of Radiological Sciences, Policlinico Gemelli Foundation, Catholic University, Rome, Italy
| | - Alessandro Posa
- Department of Radiological Sciences, Policlinico Gemelli Foundation, Catholic University, Rome, Italy
| | - Francesca Carchesio
- Department of Radiological Sciences, Policlinico Gemelli Foundation, Catholic University, Rome, Italy
| | - Riccardo Manfredi
- Department of Radiological Sciences, Policlinico Gemelli Foundation, Catholic University, Rome, Italy
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Gökçen K, Çelik H, Kobaner M, Karazindiyanoğlu S. Laparoscopic transperitoneoscopic nephroureterectomy in a patient with situs inversus totalis. Indian J Surg 2015; 77:147-9. [PMID: 25972677 DOI: 10.1007/s12262-015-1209-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 01/05/2015] [Indexed: 01/01/2023] Open
Abstract
This article discusses the case of a 78-year-old female with painless gross hematuria. Chest X-rays showed dextrocardia with situs inversus, and whole-body computed tomography scanning showed a renal mass in the right renal pelvis, no evidence of metastasis, and mirror-image organs with left-to-right transposition, which resulted in a diagnosis of situs inversus totalis (SIT). A laparoscopic transperitoneoscopic right nephroureterectomy was scheduled. To our knowledge, our case is the second case of laparoscopic nephroureterectomy in renal pelvic urothelial carcinoma with SIT to be presented, but it is the first case of laparoscopic transperitoneoscopic nephroureterectomy. Laparoscopic transperitoneoscopic nephroureterectomy was successfully performed in a renal pelvic urothelial carcinoma patient with SIT with a correct description of renal vascularity and abdominal anatomy.
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Affiliation(s)
- Kaan Gökçen
- Department of Urology, Osmaniye State Hospital, Osmaniye, Turkey
| | - Hüseyin Çelik
- Department of Urology, Inonu University Turgut Ozal Medical Center, Malatya, Turkey
| | - Murat Kobaner
- Department of Urology, Osmaniye State Hospital, Osmaniye, Turkey
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Ang WC, Doyle T, Stringer MD. Left-sided and duplicate inferior vena cava: a case series and review. Clin Anat 2012; 26:990-1001. [PMID: 22576868 DOI: 10.1002/ca.22090] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 03/23/2012] [Accepted: 03/31/2012] [Indexed: 01/21/2023]
Abstract
Left-sided and duplicate inferior vena cava (IVC) are two major anatomical variants within the spectrum of IVC malformations, both of which are developmental abnormalities of the supracardinal veins. Four clinical cases are described to highlight the computed tomographic appearances of these vascular malformations and provide novel data on venous dimensions. A systematic review of the recent literature (2000-2011) was conducted focusing on the anatomy, demographics, and associated pathology (congenital and acquired) of isolated left-sided and duplicate IVC. A total of 73 relevant articles were retrieved, consisting of case reports and small case series. The prevalence of left-sided IVC is about 0.1-0.4% and that for duplicate IVC about 0.3-0.4%; both anomalies show a slight male preponderance. In each condition, there are documented variations in the course and tributaries of the IVC. The clinical importance of these anomalies lies in three principal areas: the potential for misdiagnosis on imaging; technical difficulties during retroperitoneal surgery (particularly abdominal aortic aneurysm repair and live donor nephrectomy); and their significance in relation to the etiology and management of venous thromboembolism.
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Affiliation(s)
- Wee Choen Ang
- Department of Anatomy, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand
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Wang LH, Liu B, Wu Z, Yang Q, Xiao L, Chen W, Sheng H, Luo W, Luo R, Sun Y. Left Transperitoneal Laparoscopic Partial Nephrectomy in the Presence of a Left-sided Inferior Vena Cava. Urology 2011; 78:469-73. [DOI: 10.1016/j.urology.2011.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 03/01/2011] [Accepted: 03/08/2011] [Indexed: 11/25/2022]
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