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Review
. 2024 Oct 14;13(20):6125.
doi: 10.3390/jcm13206125.

Extrarenal Visceral Arteries Injuries during Left Radical Nephrectomy: A 50-Year Continuing Problem

Marco Catarci  1 , Leonardo Antonio Montemurro  1 , Michele Benedetti  1 , Paolo Ciano  1 , Massimiliano Millarelli  2 , Roberto Chiappa  2
Affiliations
Review

Extrarenal Visceral Arteries Injuries during Left Radical Nephrectomy: A 50-Year Continuing Problem

Marco Catarci et al. J Clin Med. .

Abstract

Due to their proximity to the left renal hilum, injuries to the superior mesenteric artery and celiac trunk are still reported during left radical nephrectomy, whether performed via open, laparoscopic, or robotic methods. The aim of this 50-year narrative review is to emphasize the anatomical and pathophysiological bases, risk factors, and strategies for the prevention, diagnosis, and treatment of such injuries.

Keywords: celiac trunk injuries; left radical nephrectomy; superior mesenteric artery injuries.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Three-dimensional reconstruction of vascular anatomy spatial relationships on computed tomography with intravenous contrast: the patient had combined SMA and splenic artery injuries during laparoscopic left radical nephrectomy for a large renal cell carcinoma with periaortic tissue involvement.
Figure 2
Figure 2
Large renal cell cancer of the left upper kidney (empty arrow): close proximity of the origin of SMA and LRA (solid arrows) from the aorta is evident.
Figure 3
Figure 3
The Kanizsa triangle [38].
Figure 4
Figure 4
Dissection of the left renal hilum during left nephrectomy: (a) the LRA (red lines) lies posteriorly to a blood-filled LRV (blue lines); (b) once the LRA (red lines) is clipped, the LRV (blue lines) appears emptied.
Figure 5
Figure 5
Three-dimensional reconstruction of renal vascular anatomy on axial computed tomography scan with intravenous contrast: a single LRA and double RRA are easily recognizable.
See this image and copyright information in PMC

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