Division of the left renal vein as an adjunct to resection of abdominal aortic aneurysms

Neal, Hunter S.; Shearburn, Edwin W.

doi:10.1016/0002-9610(67)90342-x

Cited by 31 publications

(13 citation statements)

References 3 publications

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“…Ligation of LRV was first performed to expedite resection of a retroperitoneal tumor [12], and secondly to facilitate exposure of the renal arteries after penetrating trauma [13] or proximal aorta in aortic reconstructive surgery [14] However, this is the first report that ligation of LRV is used for interruption of SRS as a prophylactic procedure of possible portal flow steal during LDLT.…”

Section: Discussionmentioning

confidence: 99%

Ligation of left renal vein for large spontaneous splenorenal shunt to prevent portal flow steal in adult living donor liver transplantation

et al. 2007

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Summary Persistance of a large spontaneous splenorenal shunt (SRS) may result in graft failure in adult living donor liver transplantation (LDLT) because it reduces the effective portal perfusion to the partial liver graft by diversion of hepatotrophic portal flow into this hepatofugal pathway. We performed a prospective study to evaluate the efficacy of ligation of left renal vein (LRV) to prevent portal flow steal and the safety of this procedure to the renal function in adult LDLT patients with SRS. Between October 2001 and January 2005, 44 cirrhotic patients with large SRS underwent LDLT with ligation of LRV. Each patient received pre‐ and postoperative computed tomography and Doppler USG to assess the changes of collaterals and portal flow, as well as serial renal and liver function tests. Portal flow after ligation of LRV was statistically and significantly increased when compared with pre‐operative value (P = 0.001). Whereas four patients (9.1%) demonstrated sustained, elevated serum creatinine levels after operation, the renal function tests returned to normal in 40 patients. All patients recovered with satisfactory regeneration of the partial liver graft and there was no procedure‐related permanent renal dysfunction. In conclusion, ligation of LRV to prevent a ‘portal steal phenomenon’ seems to be a safe and effective graft salvage procedure for large spontaneous SRS (>10‐mm diameter) in adult LDLT.

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Section: Discussionmentioning

confidence: 99%

Ligation of left renal vein for large spontaneous splenorenal shunt to prevent portal flow steal in adult living donor liver transplantation

et al. 2007

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“…Although this technique was first reported as a feasible adjunct during OS for AAA in 1967, postoperative renal function after LRVD has remained controversial. 2 Some previous studies suggested that renal hypertension caused by LRVD could result in a reduction in renal blood flow and subsequent renal impairment. 4,22, 23 According to West et al, 4 LRVD without reconstruction was significantly associated with acute renal impairment.…”

Section: Renal Volume Change After Lrvdmentioning

confidence: 99%

“…Although half a century has passed since this technique was first reported as a feasible adjunct during AAA repair in 1967, its effect on postoperative renal function remains controversial. 2 Although several prior studies suggested the safety of LRVD based on single-center series, those studies mostly referred to the effect on acute kidney injury (AKI) and rarely evaluated longer-term renal decline. [3][4][5][6][7][8] Recently, we reviewed a series of P/JRAA procedures using…”

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confidence: 99%

Effect of Intraoperative Division of the Left Renal Vein on the Fate of Renal Function and Left Renal Volume After Open Repair of Para- and Juxtarenal Aortic Aneurysm

Sugimoto

Takahashi

Niimi

et al. 2019

Circ J

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Background:The effect of left renal vein division (LRVD) during open surgery (OS) for pararenal and juxtarenal abdominal aortic aneurysm (P/JRAA) on postoperative renal function remains controversial, so we focused on chronic renal decline (CRD) and separately examined renal volume as a surrogate index of split renal function. Methods and Results:The 115 patients with P/JRAA treated with OS from June 2007 to January 2017 were reviewed: 26 patients without LRVD were matched to 27 patients with LRVD according to preoperative chronic kidney disease (CKD) stage and proximal clamp sites. The effect of LRVD on CRD was investigated by a time-to-event analysis. During a median follow-up of 23.5 months, CRD occurred in 5 patients with LRVD and in 4 patients without LRVD. Comparison of freedom from CRD showed no significant difference between the matched groups (P=0.870). The separate renal volumes were evaluated before surgery and at 1 and 2 years of follow-up using CT images from 18 patients with LRVD. At 2 years, the mean renal volume had decreased by 15% in the left kidney and by 9% in the right kidney (P=0.052 and 0.148, respectively), but the left-to-right renal volume ratio showed no significant change (P=0.647). Conclusions:LRVD had no significant effect on CRD or left renal volume relative to the right renal volume for up to 2 years.

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“…DETAILS OF THE SERIES AND POSTOPERATIVE RENAL FUNCTION TESTS divided and reconstituted the left renal vein with no harm to the patients Neal and Shearburn (1967). reported 11 patients in whom the left renal vein was permanently transected.…”

mentioning

confidence: 99%

Left renal vein ligation in surgery for abdominal aortic aneurysm

Fox

Taylor

1979

Journal of British Surgery

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Division of the left renal vein as an adjunct to resection of abdominal aortic aneurysms

Cited by 31 publications

References 3 publications

Ligation of left renal vein for large spontaneous splenorenal shunt to prevent portal flow steal in adult living donor liver transplantation

Ligation of left renal vein for large spontaneous splenorenal shunt to prevent portal flow steal in adult living donor liver transplantation

Effect of Intraoperative Division of the Left Renal Vein on the Fate of Renal Function and Left Renal Volume After Open Repair of Para- and Juxtarenal Aortic Aneurysm

Left renal vein ligation in surgery for abdominal aortic aneurysm

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