title: Celiac axis and superior mesenteric artery injury associated with left radical nephrectomy for locally advanced renal cell carcinoma.
abstract: The superior mesenteric artery and celiac axis were inadvertently ligated during left radical nephrectomy for a large upper pole renal carcinoma with massive perihilar and periaortic adenopathy. Computer-generated 3-dimensional illustrations created from the computerized tomography scan demonstrated the close proximity between these visceral branches and the adenopathy mass complex, and showed how this bulky disease may interfere with surgical anatomy. When left radical nephrectomy is performed for locally advanced and/or bulky node-positive renal neoplasms, surgeons must be cognizant of the location of the major visceral arterial branches and possible anatomical distortions.
authors.affiliation: Department of Surgery, Walter Reed Army Medical Center, Washington, D.C. 20307-5001.
authors.forename: J W
authors.initials: JW
authors.lastname: Moul
authors.forename: J P
authors.initials: JP
authors.lastname: Foley
authors.forename: G G
authors.initials: GG
authors.lastname: Wind
authors.forename: S
authors.initials: S
authors.lastname: Rubin
authors.forename: J A
authors.initials: JA
authors.lastname: Coffey
authors.forename: D G
authors.initials: DG
authors.lastname: McLeod
mesh_terms: D002292:Carcinoma, Renal Cell / Q000601:surgery*; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000628:therapy; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging / Q000293:injuries*; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D011859:Radiography; D014947:Wounds and Injuries / Q000175:diagnosis