Left Renal Vein Ligation and Preservation of Renal Function Through the Collateral Circulation after Retroperitoneal Tumor Resection

Abstract

Introduction: The retroperitoneum can present several pathologies that have a certain complexity and a poor prognosis due to their proximity to large vessels, the involvement of which complicates surgical approaches. Surgery is the therapeutic option associated with the longest survival. The objective of this study was to demonstrate that renal function can be preserved after ligation or resection of the left renal vein, without vascular reconstruction, if the collateral circulation remains functional. Case reports: We report two cases of patients with retroperitoneal tumors with local vascular invasion, the complete resection of which required division and ligation of the left renal vein. Postoperatively, both patients showed preserved renal function, because of collateral venous drainage, and vascular reconstruction was not necessary in either case. We also present a review of the literature on such cases. Conclusion: Division and ligation of the left  renal vein proved to be safe in both of the patients undergoing retroperitoneal tumor resection, and reconstruction of the vein is not mandatory when the collateral circulation is preserved.