11-13) Given the involvement of tumour thrombus invading into the IVC from two renal veins
, we felt an open midline incision enabled an easier approach and minimized the risk of complications related to adjacent abdominal organs.
As described in the literature, in some case, more than one variation can coexist as double IVC with retroaortic right renal vein
and hemiazygos continuation of the IVC, duplication of the inferior vena cava with azygos continuation, and retroaortic left renal vein
and iliac vein variations.
CT reported a single renal vein
in 49 cases, but two veins were found in six cases, three veins in one and four veins in one.
2: Right kidney: 1) aorta, 2) reflected inferior vena cava, 3) renal artery, 4-6) extra-hilar branches of renal artery, 7) cut end of renal vein
, 8-10) segmental branches of renal artery, 11) ureter.
However, in more than one third of cases, it is possible to find the right renal artery anteriorly and crisscrossed with the right renal vein
(TESTUT; LATARJET, 1978).
The right renal vein
is absent represented by long tortuous collateral draining into hypoplastic segment of IVC (Fig.
The renal vein
was anastomosed first with the external iliac vascular clamps were removed from the external iliac vein and a single vascular clamp was applied on the grafted renal vein
anatomy and its implications for retroperitoneal surgery.
According to Testut & Latarjet, the renal vein
variations are probably related to the development of the inferior cava vein and they are not associated to arterial variations.
The primary tumor may extend to the renal veins
or vena cava (large vein returning blood to the heart located in the middle of the abdomen near the back), but has only extended directly and not out of the local area of the kidney.
The right and left renal veins
were draining into the ipsilateral IVC.
Lumbar veins drain blood from the abdominal wall and vertebral venous plexus into the inferior vena cava, ascending lumbar veins, renal veins
, or lumbar azygous vein.