Left-sided laparoscopic para-aortic lymphadenectomy: Anatomy of the ventral tributaries of the infrarenal vena cava

Possover, Marc; Plaul, Karin; Krause, Norman; Schneider, Achim

doi:10.1016/s0002-9378(98)70150-4

Cited by 11 publications

(12 citation statements)

References 4 publications

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“…VTs were found in all three levels in one-third of specimens, unlike Possover, who detected none. No specimen lacked a VT, unlike Possover, who documented 21.43% patients with no VTs (Possover et al 1998). Results of both studies are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 98%

“…These are minor injuries, although blood loss in the opening of the IVC can cause serious complications in terms of orientation in the bleeding operative field. Only Possover et al (1998) have described the anatomical distribution of minute veins that lead into the IVC. This retrospective study reviewed 112 systematic right-sided pelvic lymphadenectomies based on video recordings of the surgery.…”

Section: Introductionmentioning

confidence: 99%

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Complications in right‐sided paraaortic lymphadenectomy: ventral tributaries of the inferior vena cava

et al. 2013

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The purpose of this study was to describe the distribution and structure of ventral tributaries leading into the inferior vena cava where right-sided paraaortic lymphadenectomy is performed. The study examined 21 retroperitoneal specimens by graphic reconstruction, statistical evaluation, and histological examination of ventral tributaries (VTs). Seventy VTs were identified. The average number per specimen was 3.33. There were 20, 40, and 40% of VTs found in Levels I, II, and III, respectively. During the preparation, we observed an unusual arrangement of the IVC wall, into which VTs were led through a preformed sleeve-like channel and anchored near the lumen. This finding is a key mechanism that explains the ease with which VTs are extracted during surgery. Knowledge of the distribution and histological structure of VTs allows proper orientation of the retroperitoneal area of the front wall of inferior vena cava, which is essential for uncomplicated right-sided paraaortic lymphadenectomy. The histological structure of the VT ostium within the wall of the inferior vena cava explains why injury is easy during the procedure.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Complications in right‐sided paraaortic lymphadenectomy: ventral tributaries of the inferior vena cava

et al. 2013

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“…Die kraniale Begrenzung der Resektion stellt die Mün-dung der Nierenvenen dar. Durch Abschieben des Fett-/ Lymphknotenpaketes mit intermittierender gezielter Koagulation und Durchtrennung von Perforatoren der Vena cava (systematisiert in Possover et al [15] ) kann das Prä-parat entwickelt und über den suprasymphysären Trokar geborgen werden. Alternativ zur direkten Entfernung können die Lymphknoten auch intraabdominal in z.B.…”

Section: Technikunclassified

Laparoskopische Lymphonodektomie: Technik und Ergebnisse

Fleisch¹,

Rein²

2009

Gynäkol Geburtshilfliche Rundsch

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Seit etwa 20 Jahren erfährt die Technik der laparoskopischen pelvinen und paraaortalen Lymphonodektomie eine zunehmende Popularität als Bestandteil minimalinvasiver operativer Behandlungskonzepte von Patientinnen mit gynäkologischen Tumorerkrankungen. Insbesondere Patientinnen mit frühem Zervix- und Endometriumkarzinom können unter der Voraussetzung gleicher chirurgischer Radikalität die bekannten Vorteile eines minimalinvasiven Behandlungsmodus in Anspruch nehmen. Die publizierten Machbarkeits- und Fall-Kontroll-Studien suggerieren vergleichbare Radikalitätskenngrössen, wie z.B. die Zahl entfernter Lymphknoten, zeigen aber auch potenzielle Vorteile wie einen geringeren intraoperativen Blutverlust, eine geringere stationäre Verweildauer und postoperative Komplikationsrate gegenüber dem konventionellen Verfahren auf. Verlässliche Daten zum Langzeitüberleben aus prospektiv randomisierten Studien stehen noch aus, sind aber für die nahe Zukunft zu erwarten.

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“…Usually, anatomical understanding of the IVC is restricted to its segments, major tributaries, and most common anomalies. Possover 2 and Turyna 3 divided these tributaries into four levels. Tributaries at the area of bifurcation of IVC are considered as level 1.…”

Section: Introductionmentioning

confidence: 99%

“…Each individual possesses 2 to 3 ventral tributaries. 2,3 Lymph node status is an important prognostic indicator of the treatment outcomes among common gynecological cancers (cervical and endometrial cancers). 4 Para-aortic lymphadenectomy (PLA) is a standard procedure in gynecologic oncology and is used for the treatment of ovarian, endometrial, and cervical cancers.…”

Section: Introductionmentioning

confidence: 99%

A “Dangerous Vessel” — Description of a potentially hazardous vein during para-aortic lymphadenectomy

et al. 2020

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Background and Objectives Tributaries of inferior vena cava (IVC) are not completely described. As IVC has a complex developmental origin, variations in the feeding vessels are common. The main objective of this study was to report the occurrence of any ventral tributary in the level 1 region of IVC. During the study, origin of such ventral tributary and course was also noted. Methodology In a retrospective/prospective observational study from 2015 to 2018, comprising 168 para-aortic lymphadenectomy (PLA) procedures conducted at Department of Gynaecological Oncology, University Hospital of Ulm, Germany, the presence of ventral tributaries of IVC was evaluated. Results Out of 148 retrospective cases of PLA, the presence of a prominent ventral tributary within 2 cm distance from the bifurcation of aorta was assumed in more than 60% cases. Within 20 prospectively assessed cases, the vein could be identified in 17 patients and was located within the right mesoureter. Only on one patient, this feeding vessel was draining into IVC at the level below the aortic bifurcation. Conclusion In 85% of the prospectively assessed patients considered in the study, there was a constant ventral tributary feeding the IVC within 2 cm from the bifurcation of the aorta.

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Left-sided laparoscopic para-aortic lymphadenectomy: Anatomy of the ventral tributaries of the infrarenal vena cava

Cited by 11 publications

References 4 publications

Complications in right‐sided paraaortic lymphadenectomy: ventral tributaries of the inferior vena cava

Complications in right‐sided paraaortic lymphadenectomy: ventral tributaries of the inferior vena cava

Laparoskopische Lymphonodektomie: Technik und Ergebnisse

A “Dangerous Vessel” — Description of a potentially hazardous vein during para-aortic lymphadenectomy

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