LEFT-SIDED LAPAROSCOPIC PARAAORTIC LYMPHADENECTOMY - ANATOMY OF THE VENTRAL TRIBUTARIES OF THE INFRARENAL VENA-CAVA

Citation
M. Possover et al., LEFT-SIDED LAPAROSCOPIC PARAAORTIC LYMPHADENECTOMY - ANATOMY OF THE VENTRAL TRIBUTARIES OF THE INFRARENAL VENA-CAVA, American journal of obstetrics and gynecology, 179(5), 1998, pp. 1295-1297
Citations number
8
Categorie Soggetti
Obsetric & Gynecology
ISSN journal
00029378
Volume
179
Issue
5
Year of publication
1998
Pages
1295 - 1297
Database
ISI
SICI code
0002-9378(1998)179:5<1295:LLPL-A>2.0.ZU;2-F
Abstract
OBJECTIVE: We evaluated the anatomy of the infrarenal portion of the h uman inferior vena cava and their ventral tributaries by video laparos copy. STUDY DESIGN: A total of 112 patients underwent laparoscopic par a-aortic lymphadenectomy for gynecologic malignancies. All procedures were videotaped. The number and anatomic distribution of the infrarena l tributaries of the anterior part of the inferior vena cava was evalu ated retrospectively from videotapes. The inferior vena cava was divid ed into 3 levels: the area of the bifurcation of the vena cava (level 1), the area between the bifurcation and the inferior mesenteric arter y (level 2), and the area between the inferior mesenteric artery and t he right ovarian vein (level 3). RESULTS: Tributaries were found in le vel 1 in 65 (58%) patients, in level 2 in 22 (19.6%) patients, and in level 3 in 1 (0.90%) patient; in 24 (21.5%) patients no tributaries we re found. A total of 237 tributaries was counted: 82.3% (195 of 237) w ere located at level 1, 17.3% (41 of 237) at level 2, and 0.4% (1 of 2 37) at level 3. Patients with tributaries had a mean of 3 tributaries in level 1, a mean of 1.7 tributaries in level 2, and 1 patient had 1 tributary in level 3. CONCLUSIONS: The ventral tributaries of the infe rior vena cava show a specific distribution pattern. The knowledge of these anatomic landmarks can be important for laparoscopic surgeons to avoid accidental injury.