agxАндрология и генитальная хирургияAndrology and Genital Surgery2070-97812412-890210.17650/2070-9781-2014-3-52-61agx-107Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL REPORTКлиническое значение вариантов строения нижней полой вены и брюшного отдела аорты в хирургии забрюшинного пространстваThe clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgeryМухтарулинаСветлана ВалерьевнаMukhtarulinaS. V.

Москва

Moscow

svmukhtarulina@yandex.ruКапринА. Д.KaprinA. D.svmukhtarulina@yandex.ruАсташовВ. Л.AstashovV. L.

Москва

Moscow

svmukhtarulina@yandex.ruБобинА. Н.BobinA. N.

Москва

Moscow

svmukhtarulina@yandex.ruАсееваИ. А.AseevaI. A.

Москва

Moscow

svmukhtarulina@yandex.ruФГКУ «Главный военный клинический госпиталь им. акад. Н.Н. Бурденко» Минобороны РоссииРоссияAcad. N.N. Burdenko Main Military Clinical Hospital, Ministry of Defence of RussiaRussian FederationФГБУ «Московский научно-исследовательский онкологический институт им. П.А. Герцена» Минздрава РоссииРоссияP.A. Gertsen Moscow Scientific and Research Oncology Institute, Ministry of Health of RussiaRussian Federation2014061220141535261Copyright © Мухтарулина С.В., Каприн А.Д., Асташов В.Л., Бобин А.Н., Асеева И.А., 20142014Мухтарулина С.В., Каприн А.Д., Асташов В.Л., Бобин А.Н., Асеева И.А.Mukhtarulina S.V., Kaprin A.D., Astashov V.L., Bobin A.N., Aseeva I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://agx.elpub.ru/jour/article/view/107Цель

Цель: изучить варианты строения нижней полой вены (НПВ) и ее притоков, аорты и ее ветвей ниже уровня левой почечной вены (ЛПВ) и их клиническое значение в хирургии забрюшинного пространства у больных раком шейки матки (РШМ) IA–IIB стадии.

Материалы и методы

Материалы и методы. В исследование включена 101 больная РШМ IA–IIB стадии, которым были выполнены парааортальная лимфаденэктомия, тазовая лимфаденэктомия. К основной группе отнесено 10 пациенток с наличием вариантов развития сосудов забрюшинного пространства, 91 пациентка без особенностей развития сосудов составили контрольную группу.

Результаты

Результаты. Варианты строения сосудов забрюшинного пространства были выявлены у 10 (9,9 %) пациенток. Одностороннее удвоение правой или левой почечной артерии и правой почечной вены отмечено у 5 (4,9 %) пациенток, ретроаортальная ЛПВ I или II типов – у 3 (3,0 %) больных и удвоение НПВ – у 1 (1,0 %) пациентки. Оперативное вмешательство, выполненное у 10 пациенток основной группы, не сопровождалось ятрогенным повреждением сосудов забрюшинного пространства. При проведении анализа объема интраоперационной кровопотери, уровня гемоглобина, частоты трансфузии эритроцитарной массы во время операции и количества удаленных парааортальных лимфатических узлов не было выявлено достоверных различий у пациенток сравниваемых групп. Факторы риска развития интраоперационного кровотечения у больных РШМ в зависимости от наличия или отсутствия вариантов развития сосудов забрюшинного пространства не имели достоверного различия.

Выводы

Выводы. Несмотря на тот факт, что с вариантами строения сосудов забрюшинного пространства мы сталкиваемся редко (9,9 % случаев), успех хирургии забрюшинного пространства неразрывно связан со знаниями особенностей развития сосудов, способствующими снижению риска возникновения серьезных, жизнеугрожающих осложнений.

Objective

Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.

Materials and methods

Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.

Results

Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 %) patients. Supernumerary renal arteries and veins observed in 5 (4.9 %) patients; retroaortic left renal vein type I and II – in 3 (3.0 %) patients. Double vena cava inferior detected in 1 (1.0 %) patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.

Conclusion

Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %), the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

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The authors declare that there are no conflicts of interest present.