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Left Renal Vein Reconstruction After Right Nephrectomy and Inadvertent Left Renal Vein Ligation: A Case Report and Review of the Literature

Department of Surgery, New York University School of Medicine, New York, New York

George Plitas, MD

Department of Surgery, New York University School of Medicine, New York, New York

Bart E. Muhs, MD

Department of Surgery, New York University School of Medicine, New York, New York

Michael Stifelman, MD

Department of Surgery Urology, New York University School of Medicine, New York, New York

Thomas S. Maldonado, MD

Department of Surgery, New York University School of Medicine, New York, New York, thomas.maldonado{at}med.nyu.edu

Left renal vein ligation has been used as a technical aid to gain exposure to the perirenal aorta and to control bleeding in abdominal aortic operations. Left renal vein ligation is considered to be well tolerated in patients with 2 functioning kidneys, but has rarely been described in the setting of concomitant right nephrectomy and presents a management challenge. Some reports suggest recovery of renal function may be possible after left renal vein ligation during right nephrectomy, but other suggest that a delay in revascularizing the left renal venous drainage may result in irreversible nephropathy. This article reports the inadvertent division of the left renal vein during right nephrectomy. Renal failure ensued postoperatively. The left renal vein was reconstructed, and renal function was recovered. The inability to reliably predict which patients will have adverse outcome after left renal vein ligation in the setting of a right nephrectomy may necessitate preemptive intervention.

Key Words: Left renal vein • Renal failure • Right nephrectomy

Vascular and Endovascular Surgery, Vol. 40, No. 5, 421-424 (2006)
DOI: 10.1177/1538574406290293


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