ВАРИАНТЫ СТРОЕНИЯ НИЖНЕЙ ПОЛОЙ ВЕНЫ И ЕЕ ПРИТОКОВ: КЛАССИФИКАЦИЯ, ЭМБРИОГЕНЕЗ, КОМПЬЮТЕРНАЯ ДИАГНОСТИКА И КЛИНИЧЕСКОЕ ЗНАЧЕНИЕ ПРИ ПАРААОРТАЛЬНОЙ ЛИМФОДИССЕКЦИИ

Defect of the embryogenesis of the three paired cardinal veins and their anastomoses leads to the formation of the inferior vena cava abnormalities. Congenital anomalies of the inferior vena cava (IVC) and its tributaries are usually asymptomatic. The computed tomographic (CT) imaging with intravenously administered contrast material is used for identification of the vascular structures and abnormalities. Knowledge of the anomalies of the vessels help the surgeons to avoid the development of complications by the para-aortic lymph node dissection in patients with neoplasm’s of the testis, kidney, and female genital tract. This article reviews the classification, embryogenesis, anatomy, CT imaging and clinical significance in para-aortic lymphadenectomy of the variants of the IVC and its tributaries.Нарушение эмбрионального развития 3 парных кардинальных вен и их анастомозов ведет к формированию большого разнообразия вариантов строения нижней полой вены (НПВ) и ее притоков. В большинстве случаев нарушения строения НПВ и ее притоков протекают бессимптомно. Для определения вариантов строения сосудов забрюшинного пространства в клинической практике широко используется компьютерная томография (КТ) с внутривенным усилением. Знание особенностей строения сосудов забрюшинного пространства помогает хирургам избежать развития осложнений во время парааортальной лимфодиссекции у больных со злокачественными опухолями яичка, почек и злокачественными опухолями женского полового тракта. В статье рассматриваются вопросы классификации, эмбриогенеза, анатомии, КТ и клинического значения в хирургической практике наиболее часто встречающихся вариантов строения НПВ и ее притоков

VARIANTS OF THE INFERIOR VENA CAVA AND ITS TRIBUTARIES: THE CLASSIFICATION, EMBRYOGENESIS, CT IMAGING AND CLINICAL SIGNIFICANCE IN PARA-AORTIC LYMPHADENECTOMY

<p>Defect of the embryogenesis of the three paired cardinal veins and their anastomoses leads to the formation of the inferior vena cava abnormalities. Congenital anomalies of the inferior vena cava (IVC) and its tributaries are usually asymptomatic. The computed tomographic (CT) imaging with intravenously administered contrast material is used for identification of the vascular structures and abnormalities. Knowledge of the anomalies of the vessels help the surgeons to avoid the development of complications by the para-aortic lymph node dissection in patients with neoplasm’s of the testis, kidney, and female genital tract. This article reviews the classification, embryogenesis, anatomy, CT imaging and clinical significance in para-aortic lymphadenectomy of the variants of the IVC and its tributaries.</p

The clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgery

Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 %) patients. Supernumerary renal arteries and veins observed in 5 (4.9 %) patients; retroaortic left renal vein type I and II – in 3 (3.0 %) patients. Double vena cava inferior detected in 1 (1.0 %) patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %), the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.</em