Experimental model of lower pole nephrectomy using human 3-dimensional endocasts: analysis of vascular injuries.

OBJECTIVE To establish an experimental model for lower pole nephrectomy using 3-dimensional endocasts of human kidneys. METHODS We studied 38 adult kidneys. The ureters, veins, and arteries were dissected and injected with yellow, blue, and red polyester resin, respectively. While the resins were still in a gel state, we performed lower pole guillotine sections at various distances from the hilar zone. The sample was divided into 4 groups: A, At hilar zone (11 kidneys); B, 0.5 cm from the hilar zone (12 kidneys); C, 1.0 cm from the hilar zone (8 kidneys); and D, 1.5 cm from the hilar zone (7 kidneys). RESULTS A At hilar zone-arteries: in 4 cases (36.36%), the lower segmental artery (LSA) was injured; veins: in 5 cases (45.45%), the lower venous trunk was injured (LVT). B: 0.5 cm from the hilar zone-arteries: the LSA was injured in 1 case (8.3%); veins: in 4 cases (33.3%), a lesion occurred to the LVT. C: 1.0 cm from the hilar zone-arteries: there were no lesions to LSA, but the infundibular arteries were damaged in all cases; veins: the interlobular veins were damaged in 3 of 11 cases (27.27%). D: 1.5 from the hilar zone-arteries: we observed lesions to the infundibular arteries in all cases; veins: arcuate veins were damaged in 4 of 7 cases (57.14%). CONCLUSION Lower pole nephrectomies performed at less than 1.0 cm from the hilar zone presented a significantly high incidence of injuries to large arteries and veins.