Implicaciones clínicas y quirúrgicas de las variaciones anatómicas vasculares del riñón

Abstract

Introduction: Precise knowledge of the most frequent types of renal vascular anatomical variations, as well as the adequate clinical evaluation is of great importance during laparoscopic donor nephrectomy and during renal vascular reconstruction using kidney allografts with multiple vessels. Equally important is to consider the venous anatomical variations during abdominal vascular reconstruction, particularly when performing an abdominal aortic aneurysm repair, because of the outstanding proportion of renal vascular variations that are associated with this pathology. In addition, it is ideal to think carefully about these variations when a pelvic congestion syndrome or hematuria diagnosis is encountered. Materials and methods: This paper reviews the incidence, diagnosis, surgical procedures, and clinical syndromes associated with renal anatomical vascular variations. We conducted this review taking into account the following Mesh terms: “Renal Artery/abnormalities”[Mesh] OR Renal Veins/abnormalities”[Mesh] AND “surgery”[Mesh] OR “ransplantation”[Mesh] OR “radiography”[Mesh] “Kidney Pelvis/abnormalities”[Mesh] AND “Kidney Pelvis/blood supply”[Mesh]. These terms were adapted with each of the database that was consulted: MEDLINE/PubMed, MEDLINE OVID, SCIENCEDIRECT, HINARI and LILACS. Development: The source and the most frequent types of the vascular anomalies of the kidney were reviewed. We investigated about the associated clinical syndromes and the surgical consequences in kidney transplant.

Introdução. Conhecer e diagnosticar as variações mais freqüentes da vasculatura renal é de grande importância para a planificação da nefrectomia laparoscópica no doador e para a reconstrução vascular no transplante renal. De igual forma, considerar as variações vasculares -especialmente as do sistema venoso- é indispensável em reconstrução vascular devido à grande proporção de variações venosas associadas a aneurismas da aorta abdominal; além disso, é ideal no estudo de condições clínicas tais como a síndrome de congestão pélvica e a hematúria. Metodologia. Trata-se de uma revisão da bibliografia sobre a proporção, diagnóstico, procedimentos cirúrgicos e síndromes clínicas associadas às variações da vasculatura renal, baseada no material encontrado com a seguinte estratégia de procura: "Renal Artery/abnormalities"[Mesh] OR Renal Veins/abnormalities"[Mesh] AND "surgery"[Mesh] OR "transplantation"[Mesh] OR "radiography"[Mesh] "Kidney Pelvis/abnormalities"[Mesh] AND "Kidney Pelvis/blood supply"[Mesh]. Esta estratégia se modificou de acordo com as bases de dados: MEDLINE/PubMed, MEDLINE OVID, SCIENCEDIRECT, HINARI y LILACS. Desenvolvimento. Se revisou a origem e os tipos mais freqüentes de variações da vasculatura renal. Se investigou sobre as implicações cirúrgicas e as síndromes clínicas associadas.