| Part OneStudy of applied anatomy of accessory renal artery in Chinese adults and its clinical valueObjective To explore the anatomical characteristics of accessory renal artery in Chinese adults for clinical application.Methods A total of105Chinese mature cadavers (75male and30female) were dissected. Whether there was accessory renal artery was observed. The numbers, starting points, length, outer diameter and position of each accessory renal artery, as well as the number, length and outer diameter of renal artery and the distance between the midpoints together with the angle between the two were measured and analyzed respectively.Results Accessory renal artery was observed in57cadavers, and the appearance of accessory renal artery was54.3%. The appearance of accessory renal artery was29.5%(31/105) in left and39.0%(41/105) in right kidney. The average number of left accessory renal artery was1.16±0.37and the average number of right accessory renal artery was1.29±0.60. All of the left renal arteries and accessory renal arteries originated from the abdominal aorta, except one left accessory renal artery originated from inferior artery of suprarenal gland. All of the right renal arteries and accessory renal arteries originated from the abdominal aorta, except one right accessory renal artery originated from celiac trunk. The distance between the midpoints of left accessory renal artery and renal artery was0.3-91.7mm, and the average was (23.08±24.25) mm. The angle between them was0.0-95.0°, and the average was (15.75±25.77)°. The distance between the midpoints of right accessory renal artery and renal artery was2.0-106.0mm, and the average was (27.11±28.29) mm. The angle between them was0.0-82.0°, and the average was (20.02±22.95)°. The length and the outer diameter of left accessory renal artery was13.4-81.0mm and1.2-8,5mm, the average was (43.28±14.40) mm and (4.04±1.77) mm. The length and the outer diameter of left renal artery was20.0-63.2mm and3.5-13.3mm, the average was (43.59±8.89) mm and (7.48±1.92) mm. The length and the outer diameter of right accessory renal artery was14.0-90.6mm and1.2-9.3mm, the average was (54.74±16.87) mm and (3.99±1.65) mm. The length and the outer diameter of renal artery was19.0-88.6mm and3.2-12.0mm, the average was (56.66±13.70) mm and (7.30±2.15) mm. There was significant difference between length of left and right accessory renal artery and renal artery. There was also significant difference between the outer diameter of accessory renal artery and renal artery on the same side. But there was no significant difference in other indexes. There was no significant difference between the position and relationship of both sides of accessory renal artery and renal artery.Conclusion Detailed and accurate data obtained from this study has important value for urological surgery as well as diagnosis and treatment of kidney-related disorders. Part TwoAn in vitro study of the blood supply ratios of renal feeding arteries in people with single accessory renal arteryObjective To study the volume ratios of tissues supplied by feeding arteries in isolated kidneys with single accessory renal artery and the correlation between the volume ratios and feeding arteries.Methods A total of40kidneys (19left kidneys and21right ones) from people with single accessory renal artery were studied. The outer diameter of each renal artery and accessory renal artery (DRA and DARA) were measured and the outer diameter ratios of renal feeding arteries (Dr) were calculated. Then colored cast specimens of tissue supplied by renal artery and accessory renal artery were made by acrylonitrile butradiene styrene (ABS) respectively, volume of specimens (VRA and VARA) were measured and the volume ratios (Vr) were calculated. Correlation analysis was performed to find out the correlation between V and D as well as Vr and Dr. Regression analysis was performed when necessary.Results The outer diameter of left renal artery and accessory renal artery was4.5-11.3mm and1.2-7.0mm, the average was (7.31±1.68) mm and (3.69±1.55) mm. The outer diameter of right renal artery and accessory renal artery was4.3-10.8mm and1.5-7.1mm, the average was (7.39±1.82) mm and (3.79±1.32) mm. Volume of cast specimens supplied by renal artery and accessory renal artery was20.13-92.60cm3and2.72-44.78cm3, the average was41.09±14.74cm3and17.42±9.57cm3. The proportion was37.51%-94.85%and5.15%-62.49%, the average was (70.07±13.88)%and (29.93±13.88)%. Volume of cast specimens supplied by left renal artery and accessory renal artery was21.95-92.60cm3and3.60-41.04cm3, the average was (41.17±16.66) cm3and (17.23±9.37) cm3. The proportion was49.64%-92.92%and7.08%-50.36%, the average was (70.05±13.06)%and (29.95±13.06)%. Volume of cast specimens supplied by right renal artery and accessory renal artery was20.13-74.65cm3and2.72-44.78cm3, the average was (41.02±13.18) cm3and (17.60±9.98) cm3. The proportion was37.51%-94.85%and5.15%-62.49%, the average was (70.08±14.91)%and (29.92±14.91)%. There was no significant correlation between DRA and VRA, but DARA and VARA showed linear correlation in3groups of the overall, left and right kidneys. Correlation coefficient of them was0.703,0.723and0.668. Dr and Vr also showed linear correlation in3groups. Correlation coefficient of Dr and Vr was0.823in the whole group, the regression equation of them was Vr=-1.681+2.461×Dr. Correlation coefficient of DrL and VrL was0.711, the regression equation of them was VrL=-0.894+1.987×DrL. Correlation coefficient of DrR and VtR was0.898, the regression equation of them was VrR=-2.168+2.800×DrR.Conclusion The outer diameter ratios of renal feeding arteries and the corresponding volume ratios showed linear correlation in people with single accessory renal artery. When the outer diameter of the renal artery and accessory renal artery was similar, blood supply ratio of them is similar. When outer diameter of the renal artery was5times that of accessory renal artery or more, blood supply ratio of the renal artery could meet or exceed90%. |
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