[Partial nephrectomy in cancer of the upper pole of kidney. Anatomical bases].

Abstract

On the basis of their importance for nephron-sparing surgery in tumors of the superior pole of the kidney, we analyzed 3-dimensional endocasts of the intrarenal structures. In 86.6% the superior pole was related to 3 arteries involved in its resection. Management of the superior (apical) segmental artery is in general simple as well as the ligature of the artery related to the anterior surface of the upper infundibulum. Ligature of the branch of the posterior segmental artery, that is related to the upper infundibulum, is critical due to the risk of injuring this segmental artery with loss of a great portion of renal parenchyma. The posterior segmental artery (retropelvic artery) is involved and must be preserved in all cases of superior pole resection. A retropelvic vein with its upper dorsal plexus was present in 69% of the cases. This vein must be previously ligated to provided safe management of the arteries during superior pole resection.