Article Text

Download PDFPDF
EP980 Gonadal vein graft after retroaortic left renal vein injury during paraaortic lymphadenectomy: a case report
  1. S Seyfettinoglu1,
  2. G Khatib1,
  3. U Kucukgoz Gulec1,
  4. AB Guzel1,
  5. Y Bayazit2 and
  6. MA Vardar1
  1. 1Obstetrics and Gynaecology, Gynaecologic Oncology
  2. 2Urology, Cukurova University Faculty of Medicine, Adana, Turkey


Introduction/Background Pelvic and paraaortic lymphadenectomy is a major component of the surgical staging procedure for several gynecological malignancies. The removal of these lymph nodes needs expertise as there is a danger of the major vessel injury during the surgery. In this presentation We would like to report a case in which there was an accidental injury to the left renal vein during para-aortic lymphadenectomy.

Methodology Case: 42 years old patient referred to our clinic with abdominal mass and ascites. After systemic examination, imaging, paracentesis cytology with serous adenocarcinoma and tumor board decision the patient received three cycles of neo-adjuvant chemotherapy followed by interval debulking surgery. During paraaortic lymphadenectomy nearly half of left renal vein was accidentally ligated and cut with ultrasonic energy device. Left renal vein was retroaortic. After haemostasis we evaluate the renal circulation and was of the opinion that residual patency of the renal vein was not adequate for functioning of the left kidney.The stump of the damaged renal vein was tied, and the venous blood of the left kidney was diverted through an end to side anastomosis of the left gonadal vein with the venacava (figure 1). On the post operative period the patient was recovered quickly. Two months later her Tc-99 DMSA and other renal examinations was normal. She is presently well.

Abstract EP980 Figure 1

Anastomosis of left gonadal vein with vena cava

Results Retroaortic left renal vein is a normal anatomical variant and its recognition is important in order to avoid complications during retroperitoneal surgery. Management of complications in the literature is various. In our case report, using the gonadal vein as an alternative to the left renal vein saved the patient from nephrectomy.

Conclusion Gonadal vein graft for maintaining renal circulation can be a good alternative management in renal vein injuries.

Disclosure Nothing to disclose.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.