İnferior Vena Kava, Renal Venler ve Sol Renal Venin Posterior Lomber Dallarının Anatomik Varyasyonlarının Yüzdeleri ve Cinsiyet Dağılımı Sol Renal Ven Drenaj Varyasyonları

Yıl 2023, , 1 - 8, 16.03.2023

Şerife Leblebisatan

https://doi.org/10.31832/smj.1001076

Öz

Amaç: Bu çalışmanın amacı, inferior vena kava (İVK), renal venler ve sol renal venin posterior lomber dallarının varyasyonlarının yüzdelerini ve cinsiyet dağılımını araştırmaktı.
Gereç ve Yöntemler: Bu kesitsel gözlemsel çalışma için 1949 hastanın bilgisayarlı tomografi (BT) görüntüleri retrospektif olarak değerlendirildi.
Bulgular: Bu çalışmada çift İVK, sol İVK ve azigos veni ile devam eden İVK kesintisi yüzdeleri sırasıyla %0,50, %0,20 ve %0,10; sirkumaortik sol renal ven %6 ve retroaortik sol renal ven %4,20 idi. Multipl renal ven varyasyonları sağda %24,10 iken solda yoktu. Renal venlerin arka lomber dalları sağda %0,15 ve solda %48 idi. Sol renal ven ve İVK varyasyonları açısından cinsiyetler arasında fark yoktu. Multipl sağ renal ven insidansı erkek hastalarda kadın hastalara kıyasla istatistiksel olarak anlamlı derecede yüksek iken (p = 0,045), sol renal venin arka lomber dalları için bunun tersi doğruydu (p = 0,035).
Sonuç: Venöz sistem çok çeşitli varyasyonlara sahiptir ve renal venöz dolaşım erkeklerde sağda sayı varyasyonları ve kadınlarda solda kollaterallerle desteklenmektedir.

Anahtar Kelimeler

Renal ven, inferior vena kava, anatomik varyasyon

Percentages and Gender Distribution of Anatomic Variations of Inferior Vena Cava, Renal Veins, and Posterior Lumbar Tributaries of the Left Renal Vein Left Renal Vein Drainage Variations

Öz

Objective: The aim of this study was to investigate percentages and gender distribution of the variations of the inferior vena cava (IVC), renal veins, and posterior lumbar tributaries of the left renal vein (LRV).
Materials and Methods: For this cross sectional observational study, the computed tomography (CT) images of 1949 patients were evaluated retrospectively.
Results: In the present study, percentages of double IVC, left IVC, and IVC interruption with azygos continuation were 0.5%, 0.2%, and 0.1%, respectively; circumaortic left renal vein (CLRV) was 6% and retroaortic left renal vein (RLRV) was 4.2%. Multiple renal vein variations were 24.1% on the right, but none on the left. Posterior lumbar tributaries of the renal veins were 0.15% on the right and 48% on the left. There was no difference between genders in terms of LRV and IVC variations. While the incidence of multiple right renal veins was statistically significantly higher in male patients compared to female patients (p = 0.045), the opposite was true for the posterior lumbar tributaries of the LRV (p = 0.035).
Conclusion: The venous system has a wide variety of variations, and the renal venous circulation is supported by number variations on the right in men and collaterals on the left in women.

Anahtar Kelimeler

Renal veins, inferior vena cava, anatomic variation

Kaynakça

• Shin DS, Sandstrom CK, Ingraham CR, Monroe EJ, Johnson GE. The inferior vena cava: a pictorial review of embryology, anatomy, pathology, and interventions. Abdom Radiol (NY). 2019 Jul;44(7):2511-2527. doi: 10.1007/s00261-019-01988-3.
• Ghandour A, Partovi S, Karuppasamy K, Rajiah P. Congenital anomalies of the IVC-embryological perspective and clinical relevance. Cardiovasc Diagn Ther 2016 Dec;6(6):482-492. doi: 10.21037/cdt.2016.11.18.
• Arévalo Pérez J, Gragera Torres F, Marín Toribio A, Koren Fernández L, Hayoun C, Daimiel Naranjo I. Angio CT assessment of anatomical variants in renal vasculature: its importance in the living donor. Insights Imaging 2013 Apr;4(2):199-211. doi: 10.1007/s13244-012-0217-5.
• Walker A, Slim N, Nicholson M, Brassett C. Configuration of the extra-renal venous system in relation to the left renal vein: A cadaveric study and new proposed classification. Surgeon. 2020 Dec;18(6):349-353. doi: 10.1016/j.surge.2020.01.001.
• Duty B, Daneshmand S. Venous resection in urological surgery. J Urol 2008 Dec;180:2338-42. doi: 10.1016/j.juro.2008.08.028.
• Tucker WD, Shrestha R, Burns B. Anatomy, Abdomen and Pelvis, Inferior Vena Cava. 2020 Jul 31. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–.
• Lee HN, Hyun D, Park KB, Do YS, Kim DI, Kim HJ, et al. CT findings after left renal vein division during abdominal aortic surgery. Acta Radiol. 2020 Nov 11:284185120971845. doi: 10.1177/0284185120971845.
• Pandirajan K, Katsogridakis E, Sidloff D, Sayers RD, Bown MJ, Saratzis A. Effects of Left Renal Vein Ligation During Open Abdominal Aortic Aneurysm Repair on Renal Function. Eur J Vasc Endovasc Surg. 2020 Dec;60(6):829-835. doi: 10.1016/j.ejvs.2020.08.003.
• Baptista-Silva JC, Veríssimo MJ, Castro MJ, Câmara AL, Pestana JO. Anatomical study of the renal veins observed during 342 living-donor nephrectomies. Sao Paulo Med J. 1997 May-Jun;115(3):1456-9. doi: 10.1590/s1516-31801997000300011.
• Shaheen R, Jamil MN, Farooq U. Anatomic Patterns Of Right Renal Vein. J Ayub Med Coll Abbottabad. 2019 Jan-Mar;31(1):55-59.
• Li G, Dong J, Lu JS, Zu Q, Yang SX, Li HZ, et al. Anatomical variation of the posterior lumbar tributaries of the left renal vein in retroperitoneoscopic left living donor nephrectomy. Int J Urol. 2011 Jul;18(7):503-9. doi: 10.1111/j.1442-2042.2011.02778.x.
• Cheung KT, Wong E. Duplicated Inferior Vena Cava in a Patient With Ampullary Adenocarcinoma: A Case Report and Literature Review of Anatomical Variations. Cureus. 2020 Nov 19;12(11):e11576. doi: 10.7759/cureus.11576.
• Bouali O, Mouttalib S, Labarre D, Munzer C, Lopez R, Lauwers F, et al. [Study of renal veins by multidetector-row computed tomography scans]. Morphologie. 2014 Dec;98(323):161-5. doi: 10.1016/j.morpho.2014.03.001.
• Sośnik H, Sośnik K. Renal vascularization anomalies in the Polish population. Pol Przegl Chir. 2017 Dec 30;89(6):26-30. doi: 10.5604/01.3001.0010.6760.
• Hostiuc S, Rusu MC, Negoi I, Dorobanțu B, Grigoriu M. Anatomical variants of renal veins: A meta-analysis of prevalence. Sci Rep. 2019 Jul 25;9(1):10802. doi: 10.1038/s41598-019-47280-8.
• Çınar C, Türkvatan A. Prevalence of renal vascular variations: Evaluation with MDCT angiography. Diagn Interv Imaging. 2016 Sep;97(9):891-7. doi: 10.1016/j.diii.2016.04.001.
• Dilli A, Coşar Ayaz FS, Karacan K, Zengin K, Ayaz ÜY, Karabacak OR, et al. Evaluation of renal anomalies, inferior vena cava variations, and left renal vein variations by lumbar magnetic resonance imaging in 3000 patients. Turk J Med Sci. 2017 Dec 19;47(6):1866-1873. doi: 10.3906/sag-1611-23.
• Özgül E. Evaluating incidence and clinical importance of renal vein anomalies with routine abdominal multidetector computed tomography. Abdom Radiol (NY). 2021 Mar;46(3):1034-1040. doi: 10.1007/s00261-020-02716-y.
• Kuzan TY, Kuzan BN, Telli TA, Tüney D. Evaluation of the frequency of left renal vein variations in computed tomography and its relationship with cancer development. Folia Morphol (Warsz). 2020;79(4):793-798. doi: 10.5603/FM.a2019.0137.