Anatomical Study Of Arrangement Of Renal Hilar Structures In Indian Adult Human Cadavers
Anatomical Study Of Arrangement Of Renal Hilar Structures
DOI:
https://doi.org/10.70284/njirm.v6i3.911Keywords:
Kidney, Nephrectomy, Renal artery, Renal hilum, Renal vein, Renal pelvisAbstract
Background: Knowledge of arrangement of renal hilar structure is essential in the era of minimally invasive surgery. Nephron sparing surgeries like partial nephrectomy by laparoscope is treatment of choice and in this surgery hilar dissection is one of the important steps. However, in literature very few reports are available regarding the different patterns of dispositions of renal hilar structures. Aim of present study was to evaluate the arrangement of renal hilar structures. Methodology: Present work was carried out on fifty seven pairs of morphological normal kidneys of embalmed cadavers. Renal hilum of each kidney was dissected carefully to see the arrangement of renal artery, vein and pelvis. Results: Arrangement of renal hilar structures showed great variation. We classified arrangement of renal hilar structures into ten different patterns. In 22.80 % kidney we observed the arrangement of hilar structures according to textbooks. We observed anterior and posterior tributaries of renal vein in 32.45% and in 41.22% kidneys pelvis was the posterior most relation. Conclusion: Present study will help to understand the better knowledge of the disposition of hilar structures for the urological surgeons, radiologist and anatomists. [Jadhav S et al NJIRM 2015; 6(3): 49-53]
References
2. Sinnatamby CS. Last’s anatomy regional and applied. 11th ed. UK: Churchill Livingstone Elsevier; 2006: 294.
3. Snell RS Clinical anatomy. 9th ed. Baltimore: Lippincott Williams and Wilkins; 2012: 207.
4. Nuygen M M, Gill I S, Ellison L M. The evolving presentation of renal carcinoma in the United States: trends from surveillance, epidemiology and end results program. J Urology. 2006; 176 (6): 2397-400.
5. Huang W C, Levey A S, Serio A M, Snyder M, Vickers A J, Raj G V, Scardino P T, Russo P. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006; 7 (9): 735- 40.
6. Rogers C G, Metwalli A, Blatt A M, Bratslavsky G, Menon M, Linechan W N, Pinto P A. Robotic partial nephrectomy for renal hilar tumors: a multi-institutional analysis. J Urol. 2008; 180 (6): 2353-6.
7. Desai M M, Grill I S. Laparoscopic partial nephrectomy for tumour: current status at the Cleveland Clinic. BIU Int. 2005; 95 (2): 41-5.
8. Rapp D E, Orvieo M A, Gerber G S et al. Enbioc stapling of renal hilum during laparoscopic nephrectomy and nephroureterectomy. Urology. 2004; 64 (4): 655-59.
9. Sampaio F J, Favorito L A. Endopyelotomy. Anatomical study of the vascular relationships to ureteropelvic junction. J. Urol. 1991; 97 (2): 73-77.
10. Trivedi S, Athavale S, Kotgiriwar S. Normal and variant anatomy of renal hilar structures and its clinical significance. Int. J. Morphol. 2011; 29 (4): 1379-83.
11. Naveen Kumar, Guru A, Aswini A P, Shetty S D, Nayak B, Narendra P. Evolution of the variant anatomical disposition of the renal hilar structures in south Indian adult human cadavers and its clinical implications. J Clin Diagn Res. 2013 Aug; 7(8): 1543–46.
12. Sampaio F J, Favorito L A. Ureteropelvic junction stenosis: vascular anatomical background for endopyelotomy. J Urol. 1993; 150: 1787-91.
13. Rouviere O, Lyonnet D, Berger P et al. Uretero-pelvic junction obstruction: use of helical CT for preoperative assessment: comparison with intra-arterial angiography. Radiology. 1999; 213: 668-73.
14. Sampaio F J. The dilemma of crossing vessels at uretropelvic junction: precise anatomic study. J Endourol. 1996; 10 (5) : 411-15.
15. Jaao A Lucas S V, Kenia F C, Guilherme P G, Celina A F, Rafael A D. Analysis of renal hilum extraparenchymal structures in Brazilian adult human cadavers. Eur J Anat. 2009; 13 (3): 145-53.
16. Hassan SM, Khalil M, Khalil M. Variation in arrangement of structures at hilum of human kidney. Bangladesh Journal of Anatomy. 2012; 10 (2): 76-79.
17. Gill I S, Colombo J R, Frank I, Moinzadeh A, Kaouk J, Desai M. Laparoscopic partial nephrectomy for hilum tumors. J Uro. 2005; 174 (3): 850-54.
18. Latouff J B, Beri A, D Ambros OF, Grull M, Leeb K, Janetsehek G. Laparoscopic partial nephrectomy for hilar tumors technique and results. Eur, Urol. 2008; 54(2): 409-16.
