Surgical anatomy of infra- and suprarenal regions of inferior vena cava

V.I. Rusin, V.V. Korsak, S.O. Boiko, Ya.M. Popovych

Abstract


Background. Technology of standard vascular isolation of a segment of the inferior vena cava (IVC) by the surgical treatment of it thrombosis is well known and widely used in practice. When spreading of tumor thrombus to the level of the diaphragm and above, Pringle maneuver is applied after the piggyback-mobilization of the liver. All these actions are aimed to prevent an intraoperative bleeding. However, in clinical practice, there are cases of massive, difficult controlled intraoperative bleeding. Objective. To study the anatomical features, how the veins falls into the infra- and suprarenal regions of the inferior vena cava for the development of preventive methods of intraoperative complications during the thrombectomy and cavatomy. Materials and methods. The features of the surgical anatomy of the inferior vena cava were studied at 27 corpses of different sexes, which have died of causes not associated with oncological diseases or thrombosis of the inferior vena cava. Results. The number of posterior hepatic veins ranges from 7 to 23, and their mean diameter is 4.8 ± 1.9 mm. In the infrarenal department of IVC, there are from 2 to 8 pairs of lumbar veins, which in 92.6 % of the cases have a common trunk and in 81.5 % of cases falls into the left posterior and lateral semicircle of IVC, thus their mean diameter was 5.20 ± 2.14 mm. Conclusions. Posterior hepatic and common lumbar veins could be the source of difficult controlled bleeding during the thrombectomy.

Keywords


inferior vena cava; hepatic veins; lumbar veins; thrombectomy

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DOI: https://doi.org/10.22141/1997-2938.1.32.2017.98487

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