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Kagami Y, Nakashima H, Satake K, Ito K, Tsushima M, Segi N, Tomita H, Ouchida J, Morita Y, Ode Y, Imagama S, Kanemura T. Anatomical Analysis of the Gonadal Veins and Spine in Lateral Lumbar Interbody Fusion. J Clin Med 2023; 12:jcm12083041. [PMID: 37109377 PMCID: PMC10142342 DOI: 10.3390/jcm12083041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/05/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The current study aimed to investigate the anatomical position of the gonadal veins (GVs) from the viewpoint of spine surgery and the risk factors associated with lateral lumbar interbody fusion (LLIF). METHODS This retrospective study included 99 consecutive patients. The GV locations were divided into the ventral (V), dorsal medial (DM), and dorsal lateral (DL) sides based on lumbar disk levels on axial contrast-enhanced computed tomography images. The DM region surrounded by the vertebral body and psoas muscle had the highest risk of GV injury. The GV at each intervertebral disk level was examined in terms of laterality and sex. The patients were divided into group M (which included those with GV in the DM region at any vertebral level) and group O (which included those without GV in the DM region at any vertebral level). Then, the two groups were compared. RESULTS In the case of lower lumbar levels and in women, the GVs were commonly observed in the DM region. Group M had a higher incidence of degenerative scoliosis than group O and a significantly larger Cobb angle. CONCLUSIONS We should pay close attention to the GV location on the preoperative image when using LLIF, particularly in female patients with degenerative scoliosis.
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Affiliation(s)
- Yujiro Kagami
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
- Department of Orthopedic Surgery, Anjo Kosei Hospital, Anjo 446-8602, Japan
| | - Hiroaki Nakashima
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, Nagoya 466-8560, Japan
| | - Kotaro Satake
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
| | - Kenyu Ito
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
| | - Mikito Tsushima
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
| | - Naoki Segi
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, Nagoya 466-8560, Japan
| | - Hiroyuki Tomita
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
| | - Jun Ouchida
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, Nagoya 466-8560, Japan
| | - Yoshinori Morita
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, Nagoya 466-8560, Japan
| | - Yukihito Ode
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, Nagoya 466-8560, Japan
| | - Tokumi Kanemura
- Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan
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Maughan KS, Romain M, Brown DB. Use of Ethylene Vinyl Copolymer for Embolization Outside the Central Nervous System: A Case Review. Semin Intervent Radiol 2023; 40:221-230. [PMID: 37333750 PMCID: PMC10275679 DOI: 10.1055/s-0043-1768611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Affiliation(s)
- Kyle S. Maughan
- Department of Radiology and Radiologic Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mike Romain
- Meharry Medical College, Nashville, Tennessee
| | - Daniel B. Brown
- Department of Radiology and Radiologic Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
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Farris PC, Macciola DM, Barazani LN, Nathan JR, Quinn D, Peters DF. A Cadaveric Study on the Anomalous Origin of Renal and Gonadal Vasculature: An Observational Study. INTERNATIONAL JOURNAL OF MEDICAL STUDENTS 2022. [DOI: 10.5195/ijms.2022.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Due to the increasing prevalence of kidney transplantation, a greater awareness of variations in the surrounding vasculature is of surgical importance. During embryological development, both the renal and gonadal arteries arise from lateral mesonephric branches of the dorsal aorta. In adults, gonadal arteries are paired vessels that normally arise from the aorta at the level of the second lumbar vertebra.
Methods: Routine cadaveric dissection completed by first-year medical students and dental students incidentally revealed anatomical anomalies.
Results: We describe two cadaveric findings in male cases which demonstrate unilateral and bilateral variations of testicular arteries originating from an aberrant renal artery in one case and an accessory renal artery in the other.
Conclusion: By increasing awareness of anomalous testicular arteries we hope to encourage the standardization of preoperative vasculature exploration to both minimize intra-operative risk to living male kidney donors and increase patients’ understanding of potential risks and complications prior to consenting to the procedure providing more accurate information prior to surgery.
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Baldari L, Boni L, Della Porta M, Bertani C, Cassinotti E. Management of intraoperative complications during laparoscopic right colectomy. Minerva Surg 2021; 76:294-302. [PMID: 33855378 DOI: 10.23736/s2724-5691.21.08771-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Minimally invasive right colectomy is increasingly performed as standard treatment for diseases of right colon. Complete mesocolic excision has been introduced for cancer treatment to improve oncological results. Both standard and complete mesocolic excision techniques are associated with intraoperative complications. The purpose of this study was to analyse incidence and management of intraoperative complications in patients who underwent laparoscopic right colectomy with complete mesocolic excision in a single institution. METHODS This is a retrospective study conducted in a single Italian centre from April 2017 to October 2020. Data of non-metastatic cancer patients who underwent laparoscopic right colectomy were collected to analyse onset of intraoperative complications, their management and rate of conversion to open surgery. RESULTS A total of 92 patients were included in this study. The 1.09% of patients were converted to open surgery due to adhesions and bowel occlusion. The 5.43% of patients had intraoperative complications: bleeding from Henle's trunk, pre-pancreatic plane and ileocolic artery stump account for 3.26%, gonadal vessel injury for 1.09% and bowel lesion for 1.09%. CONCLUSIONS Despite the limits of this study, it shows that bleeding is one of the most frequent complications in laparoscopic right colectomy. Bleeding, occlusion and adhesions are most common reasons for conversion to open surgery.
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Affiliation(s)
- Ludovica Baldari
- Department of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy -
| | - Luigi Boni
- Department of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Massimiliano Della Porta
- Department of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Cristina Bertani
- Department of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Elisa Cassinotti
- Department of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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