Abstract
Variations in renal hilar arrangement patterns and morphometric dimensions are clinically relevant in this age of advancing modern medicine and minimally invasive surgery. The purpose of the present study is to record variations in renal hilar arrangement patterns and assess renal dimensions of length, width and thickness respectively. Hilar regions of fifty isolated embalmed kidneys were carefully dissected and variations observed were photographed and documented. Renal dimensions were measured with digital calipers and values obtained were tabulated and analysed. Normal anteroposterior hilar arrangement pattern was observed in 72% cases. Anterior and posterior divisions of renal artery were observed in 24% cases with anterior division being the most anteriorly placed structure in 14% cases. The renal pelvis was situated between the divisions of the renal artery in 8% cases. Prehilar segmental branches anterior to renal vein were observed in 4% cases. Other variations seen included extrahilar branches (4%), superior polar artery arising from anterior division of renal artery, prehilar tributaries of renal vein and an additional renal artery in 1 case each. The mean renal length was 9.35+/- 0.98 cm for right and 9.25 +/- 1.25 cm for left kidneys, mean renal width 4.93 +/- 0.65 cm for right and 4.95 +/- 0.5 cm for left kidneys and mean renal thickness 3.77 +/- 0.7 cm for right and 3.86 +/- 0.53 cm for left kidneys respectively. No statistically significant difference was observed in the mean values between right and left sides. The clinical implications of these findings have been discussed. The findings of this study may enhance the existing literature and contribute additional information for improving treatment outcomes during clinical and surgical interventions.
 Keywords: Variation, Hilum, Kidneys, Morphometry, Arrangement pattern, dimensions
Highlights
In this current era of rapidly advancing modern medicine, an in-depth anatomical understanding of the human body is an essential prerequisite for successfully performing medical, radiological and surgical procedures
Variations encountered in hilar anatomy were photographed and documented.The kidneys were morphometrically assessed for maximum length, width and thickness using digital calipers and values obtained were recorded.The renal dimensions were compared with respect to right and left kidneys by applying Independent t test with p value set at
Variant arrangement patterns of the hilar structures were recorded in 28% (14/50) cases.The various hilar arrangement patterns observed in the present study are depicted in table 1
Summary
In this current era of rapidly advancing modern medicine, an in-depth anatomical understanding of the human body is an essential prerequisite for successfully performing medical, radiological and surgical procedures. Shorter ischemia times, a lower complication rate, and equivalent long-term oncologic and renal functional outcomes, yet with decreased patient morbidity.4During LPN, clamping of individual structures at the hilum is preferred rather than enbloc clamping.5Recent studies have demonstrated the need for careful hilar dissection with appropriate techniques of clamping renal vessels to prevent surgical complications and reduce post operative morbidity.[6,7] A precise knowledge of normal as well as variant anatomical arrangement patterns at the renal hilum is vital for the achievement of successful surgical outcomes with reduced complications and better patient recovery
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