Left-side venous anastomosis as a method correcting blood outflow from the kidney

Abstract

Case histories and surgical protocols of 50 patients who were treated for chronic hepatitis by creating left-side renoportal venous anastomosis (RPVA) were analysed retrospectively. Early after surgery 75% patients had microhematuria, proteinuria to 0.033-0.066 g/l, leucocyturia. At discharge from the hospital these abnormalities were not registered in the majority of the patients. Three months after operation these indices were at the preoperative level. Significant shifts in parameters of urine were associated with an anomalous condition of the left renal vein (annular, retroaortal), its compression, portal hypertension and creation of RPVA without legation of the splenic vein. In a cositive compression test RPVA was created without arrest of arterial inflow for 45 min. This can be a criterion of feasibility of left renal vein ligature if left-side RPVA cannot be performed for preservation of the left kidney. Validity of left-side RPVA use for correction of blood outflow from the left kidney is proven by functional improvement and normal side of the kidneys in long-term postoperative follow-up.