tailieunhanh - Genitourinary tract imaging - part 6

nội soi để tiếp cận các nhà tài trợ nephrectomy vàng là có thể xảy ra dù một cách tiếp cận mở NUÔI Cần Phải [3]. Trong điểm này, sự hiện diện của một phép tính đơn lẻ nhỏ | 80 Singh Sahani laparoscopic approach to donor nephrectomy is possible or whether an open approach should be adopted 3 . In view of this the presence of a tiny single calculus 5 mm diameter or a cyst of same size in one of the donor kidneys is not a contraindication for its retrieval for a recipient irrespective of the complexities in its vascular variants. If both donor kidneys are normal then the kidney with the less complex vascular anatomy is preferred making a less invasive laparoscopic approach for nephrectomy feasible. The left kidney is usually preferred for a recipient because it provides a longer segment of the renal vein which joins the inferior vena cava IVC and thus provides more maneuverability to the surgeon to suture the donor vessel patch to the recipient s iliac vein. In addition to defining the vascular anatomy and variants imaging should clearly depict pathologic conditions like renal artery atherosclerosis fibro-muscular dysplasia aneurysm and thrombosis. Accessory renal arteries are seen in up to 30 of cases and they usually originate from the aorta. Occasionally these arteries may arise from the iliac arteries and rarely from the mesenteric and lumbar arteries 4 . Delineation and clear outlining of small accessory arteries which can be as small as 1 to 2mm in diameter are important imaging prerequisites from a surgical standpoint. Furthermore a clear differentiation between two separate accessory arteries from prehilar branching renal artery branching within 20 mm of renal artery origin is extremely helpful and can sometimes help avoid torrential bleeding complications 5 . Similarly multiple renal veins are seen in up to 30 of patients. An important presurgical imaging communication is confirmation of the presence or absence of venous variants such as the circumaortic renal vein a single renal vein that is split or two renal veins encircling the aorta before joining the IVC an isolated retroaortic left renal vein and abnormalities such as .