Cadaveric renal anatomic study of partial nephrectomy with segmental renal artery clamping

Objective To study the anatomic characteristics of the renal artery and segmental renal artery and their relationship with the renal hilum in order to provide a theoretical basis for partial nephrectomy with segmental renal artery clamping.Methods From 2010 to 2012,22 pairs of adult cadaveric renal specimen via conventional anti-corrosion were adopted for the research.The distance between the first branch of renal artery and the secondary branch to the line A (Line A connects upper and lower pole of the renal hilum) and the distance between the two branches were measured and comparison was made between left and right kidney respectively.The location and dominance of the accessory renal artery were analyzed.Results The average distance between the first branch and the line A was (1.0±0.7) cm,and the distance between the secondary branch and Line A was (0.4±0.3) cm,and there was no significant difference between left and right side (P＞0.05).The cases with the first branch outside the line A was 90.9％ (40/44).There were 23 cases with secondary branch outside the line A (52.3％,23/44),and 16 cases with secondary branch inside the line A (36.4％,16/44).31.8％ of the cases had accessory renal artery,among which one case had two accessory arteries.Eleven accessory arteries originated from the renal artery,while 13 accessory arteries dominated the upper pole of kidney.Conclusions The renal artery showed segmental distribution,and there was enough space between the renal artery and the renal hilum.This finding further clarifies that partial nephrectomy with segmental renal artery clamping could be safe and feasible.Accessory renal arteries arise with certain possibility,and most dominate in the upper pole of kidney.So intraoperative attention should be paid to avoid unnecessary nephron loss. Key words: Partial nephrectomy;  Segmental renal artery;  Renal hilum;  Accessory renal artery;  Anatomy, regional