Luciano A Favorito1, Francisco J B Sampaio. 1. Urogenital Research Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: lufavorito@yahoo.com.br.
Abstract
OBJECTIVE: To establish an experimental model for lower pole nephrectomy using 3-dimensional endocasts of human kidneys. METHODS: We studied 38 adult kidneys. The ureters, veins, and arteries were dissected and injected with yellow, blue, and red polyester resin, respectively. While the resins were still in a gel state, we performed lower pole guillotine sections at various distances from the hilar zone. The sample was divided into 4 groups: A, At hilar zone (11 kidneys); B, 0.5 cm from the hilar zone (12 kidneys); C, 1.0 cm from the hilar zone (8 kidneys); and D, 1.5 cm from the hilar zone (7 kidneys). RESULTS A: At hilar zone-arteries: in 4 cases (36.36%), the lower segmental artery (LSA) was injured; veins: in 5 cases (45.45%), the lower venous trunk was injured (LVT). B: 0.5 cm from the hilar zone-arteries: the LSA was injured in 1 case (8.3%); veins: in 4 cases (33.3%), a lesion occurred to the LVT. C: 1.0 cm from the hilar zone-arteries: there were no lesions to LSA, but the infundibular arteries were damaged in all cases; veins: the interlobular veins were damaged in 3 of 11 cases (27.27%). D: 1.5 from the hilar zone-arteries: we observed lesions to the infundibular arteries in all cases; veins: arcuate veins were damaged in 4 of 7 cases (57.14%). CONCLUSION: Lower pole nephrectomies performed at less than 1.0 cm from the hilar zone presented a significantly high incidence of injuries to large arteries and veins.
OBJECTIVE: To establish an experimental model for lower pole nephrectomy using 3-dimensional endocasts of human kidneys. METHODS: We studied 38 adult kidneys. The ureters, veins, and arteries were dissected and injected with yellow, blue, and red polyester resin, respectively. While the resins were still in a gel state, we performed lower pole guillotine sections at various distances from the hilar zone. The sample was divided into 4 groups: A, At hilar zone (11 kidneys); B, 0.5 cm from the hilar zone (12 kidneys); C, 1.0 cm from the hilar zone (8 kidneys); and D, 1.5 cm from the hilar zone (7 kidneys). RESULTS A: At hilar zone-arteries: in 4 cases (36.36%), the lower segmental artery (LSA) was injured; veins: in 5 cases (45.45%), the lower venous trunk was injured (LVT). B: 0.5 cm from the hilar zone-arteries: the LSA was injured in 1 case (8.3%); veins: in 4 cases (33.3%), a lesion occurred to the LVT. C: 1.0 cm from the hilar zone-arteries: there were no lesions to LSA, but the infundibular arteries were damaged in all cases; veins: the interlobular veins were damaged in 3 of 11 cases (27.27%). D: 1.5 from the hilar zone-arteries: we observed lesions to the infundibular arteries in all cases; veins: arcuate veins were damaged in 4 of 7 cases (57.14%). CONCLUSION: Lower pole nephrectomies performed at less than 1.0 cm from the hilar zone presented a significantly high incidence of injuries to large arteries and veins.