Vascular and Urinary Tract Anatomic Variants Relevant to Para-Aortic Lymphadenectomy in Women with Gynecological Cancers.

anatomy aorta gynecologic malignancy inferior vena cava para-aortic lymphadenectomy renal artery renal vein ureter urinary tract

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
12 Oct 2023
Historique:
received: 23 08 2023
revised: 08 10 2023
accepted: 10 10 2023
medline: 28 10 2023
pubmed: 28 10 2023
entrez: 28 10 2023
Statut: epublish

Résumé

Para-aortic lymphadenectomy is an essential part of gynecologic oncologic surgical treatment. The surgeon should be aware of the complex usual anatomy and its common variants. Between January 2021 and May 2023, 58 women underwent para-aortic lymphadenectomy for gynecologic malignancies. Vascular and urinary tract anatomic variants were retrospectively reviewed from the prospective institutional database and results were compared with preoperative contrast-enhanced abdominal CT. Of these 58 women, 47 women had no vascular or urinary tract variants. One woman had a double inferior vena cava, two patients were found to have a retro-aortic left renal vein, four had accessory renal arteries, two had a double left ureter, one had a ptotic kidney in the iliac fossa, and one patient had bilateral kidney malrotation. Anatomic variants in the preoperative CT were described by a radiologist in only two patients, and additional vascular and urinary tract variants were found incidentally at the time of surgery. Acknowledgment of vascular and urinary tract variants is helpful for the surgeon to establish an appropriate surgical plan and to avoid iatrogenic surgical trauma.

Sections du résumé

BACKGROUND BACKGROUND
Para-aortic lymphadenectomy is an essential part of gynecologic oncologic surgical treatment. The surgeon should be aware of the complex usual anatomy and its common variants.
METHODS METHODS
Between January 2021 and May 2023, 58 women underwent para-aortic lymphadenectomy for gynecologic malignancies.
RESULTS RESULTS
Vascular and urinary tract anatomic variants were retrospectively reviewed from the prospective institutional database and results were compared with preoperative contrast-enhanced abdominal CT. Of these 58 women, 47 women had no vascular or urinary tract variants. One woman had a double inferior vena cava, two patients were found to have a retro-aortic left renal vein, four had accessory renal arteries, two had a double left ureter, one had a ptotic kidney in the iliac fossa, and one patient had bilateral kidney malrotation. Anatomic variants in the preoperative CT were described by a radiologist in only two patients, and additional vascular and urinary tract variants were found incidentally at the time of surgery.
CONCLUSIONS CONCLUSIONS
Acknowledgment of vascular and urinary tract variants is helpful for the surgeon to establish an appropriate surgical plan and to avoid iatrogenic surgical trauma.

Identifiants

pubmed: 37894326
pii: cancers15204959
doi: 10.3390/cancers15204959
pmc: PMC10605252
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Nina Kovačević (N)

Department of Gynecological Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia.
Faculty of Health Care Angela Boškin, Spodnji Plavž 3, 4270 Jesenice, Slovenia.

Marko Hočevar (M)

Department of Gynecological Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia.

Gregor Vivod (G)

Department of Gynecological Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia.

Sebastjan Merlo (S)

Department of Gynecological Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia.

Classifications MeSH