A prospective study of the predictive power of spiral computed tomographic angiography for defining renal vascular anatomy before live-donor nephrectomy
| Autor: | Nicolas R. Brook, Michael L. Nicholson, Peter S. Veitch, Kevin Mulcahy, Gareth R. Lewis |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Urology medicine.medical_treatment Nephrectomy Sensitivity and Specificity Renal Veins Renal Artery Predictive Value of Tests medicine.artery Internal medicine Living Donors medicine Humans Prospective Studies Renal artery Retrospective Studies medicine.diagnostic_test business.industry Middle Aged Spiral computed tomography Surgery Transplantation Dissection Angiography Tissue and Organ Harvesting Female Radiology Renal vein business Tomography Spiral Computed |
| Zdroj: | BJU International. 94:1077-1081 |
| ISSN: | 1464-410X 1464-4096 |
| DOI: | 10.1111/j.1464-410x.2004.05107.x |
| Popis: | The advent of laparoscopic donor nephrectomy for renal transplantation has focused minds to an even greater degree on the vascular anatomy of the donor kidney. The authors from Leicester determined the accuracy of spiral CT imaging for donor venous anatomy and comparing it to the operative findings, either at open or laparoscopic donor nephrectomy. They found the technique to be an excellent way of assessing potential renal donors in terms of the gonadal and adrenal veins, but less so for predicting lumbar veins. OBJECTIVE To determine the accuracy of spiral computed tomography (CT) imaging of donor venous anatomy by comparing CT angiography (CTA) and operative findings, for both laparoscopic (LDN) and open donor nephrectomy. PATIENTS AND METHODS LDN presents unique surgical challenges, particularly with complex venous or arterial anatomy. The limitations of surgical access, poor visibility of the superior and posterior borders of the renal vein during LDN, and the variability of venous anatomy in this region, contribute to the difficulty of LDN, underlining the importance of imaging beforehand. Forty live donors (mean age 46 years, sd 11; 65% female) were assessed by CTA before donation. Scans were reported by the same radiologist. The number and diameter of ‘predicted’ renal arteries, veins and renal vein tributaries were documented. The donor kidney was removed by two consultant surgeons, and after back-table perfusion the same details were recorded and taken as the ‘reference’ findings. Tributaries of |
| Databáze: | OpenAIRE |
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