Document Detail


Experience in identifying the venous drainage of the adrenal gland during laparoscopic adrenalectomy.
MedLine Citation:
PMID:  18816449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Laparoscopic adrenalectomy (LA) is the procedure of choice for most adrenal tumors. An important part of LA is the early identification and ligation of the adrenal veins. The venous drainage from each adrenal gland is usually via a single vein: the right vein draining into the inferior vena cava (IVC) and the left vein into the left renal vein. Although infrequent, variable venous drainage has been documented. The aim of the study was to clarify if LA identified venous drainage and its variants. Between January 1999 and January 2008, 142 consecutive patients underwent LA. Adrenal vein anatomy was documented on a prospective database. In total, 142 patients underwent 162 LA (right = 62, left = 66, bilateral = 17). All adrenal veins were identified at the time of laparoscopy. For 157 LA, the adrenal venous drainage was constant: right vein drained into the IVC and left vein drained into left renal vein. Five patients had adrenal vein variants: two right veins draining separately into IVC (n = 1), two right veins draining into the IVC and right renal vein (n = 1), and two left veins draining separately into the left renal vein (n = 3). Adrenal vein variants were present in patients with phaeochromocytomas (n = 4) or adrenocortical carcinoma (n = 1). The laparoscopic approach allowed an excellent view of the main adrenal venous anatomy. This has helped confirm the constant nature of the venous drainage and successfully identify variant adrenal veins.
Authors:
Craig N Parnaby; Norman Galbraith; Patrick J O'Dwyer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical anatomy (New York, N.Y.)     Volume:  21     ISSN:  1098-2353     ISO Abbreviation:  Clin Anat     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-06     Completed Date:  2009-02-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809128     Medline TA:  Clin Anat     Country:  United States    
Other Details:
Languages:  eng     Pagination:  660-5     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Affiliation:
Department of Surgery, Western Infirmary, Glasgow, Scotland, UK. craigparnaby@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Neoplasms / surgery
Adrenal Gland Neoplasms / surgery
Adrenal Glands / blood supply*
Adrenalectomy*
Adrenocortical Carcinoma / surgery
Adult
Aged
Aged, 80 and over
Female
Humans
Laparoscopy*
Male
Middle Aged
Pheochromocytoma / surgery
Renal Veins / anatomy & histology
Veins / anatomy & histology*
Vena Cava, Inferior / anatomy & histology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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