TOPOGRAPHOANATOMICAL CHANGES IN ABDOMINAL CAVITY AND RETROPERITONEAL SPACE AFTER NEPHRECTOMY

Abstract

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Aim. Purpose of research - obtaining new data on changes in the topography of the abdomen and retroperitoneum after nephrectomy. Material and Methods. In 105 patients with kidney cancer, the topography of the abdomen (liver, ascending and descending colon, spleen, duodenum) and retroperitoneum (pancreas, aorta, inferior vena cava) were studied depending on the location of the tumors and their size. A group of 25 patients was studied as a control without the pathology of the kidneys. Computed tomography on the device «LightSpeed RT16» (General Electric, USA) and morphometry for the analysis of abdominal and retroperitoneal displacement after operation were used. The examinations were performed before and after 6-8 days, 3-4 months and 6-8 months after nephrectomy. Results and Discussion. After right-sided nephrectomy, the surgical bed is replaced by the ascending colon (level LI-LV), the head of the pancreas (level ThXII-LII), the inferior vena cava (level ThXII-LI), the descending part of the duodenum (level ThXII-LI) moving backwards; ascending colon (up to ThXII level) moving upwards; the right lobe of the liver (level ThXI-LI) moving medially. After left-sided nephrectomy, the remaining part of the retroperitoneum is filled with the descending colon (level ThXII-LIV) displacing posteriorly, the body and tail of the pancreas (level ThXII-LII) displacing posteriorly and medially, spleen (level ThXI) displacing medially. Conclusions. On the basis of morphometry data, a quantitative description of the displacement of organs and structures of the abdomen and retroperitoneum towards the postoperative bed to the place of the removed kidney with a malignant tumor is given.