The Anatomic Relationship of the Renal Artery and the Renal Vein to the Renal Fascia

Abstract

The anatomic relationship of the renal artery and the renal vein to the renal fascia was studied in 20 patients operated on for renal carcinoma and in 21 autopsies on cases without renal tumours. The observations were made at dissection of the tissues and on contrast roentgenograms of the extirpated kidneys. The investigated relationship is important in operations for malignant tumours of the kidney, the renal pelvis and the ureter.

The renal fascia forms the boundary for the course and supply field of the renal artery. Veins in the fatty capsule, the kidney, the suprarenal gland, the renal pelvis and the ureter run inside the ventral and dorsal leaves of the fascia and form a plexus of tributaries of the renal vein. The renal fascia thus constitutes the boundary for the catchment area of the renal vein. The gonadal veins run inside the fascial sheath of the ureter and in between the two leaves of the renal fascia. The left diaphragmatic vein enters the renal bed through the renal fascia.

Communicants to extrarenal venous regions seem to leave the renal bed in a regular pattern. They may run through the ventral leaf of the fascia to the mesocolon, through the lateral fusion of the fascia leaves to the lateral abdominal wall, and through the cranial fusion to the veins of the liver and the spleen. Through the medial extension of the fascia venous communicants pass to the lumbar plexus and also direct veins to the inferior vena cava from the right suprarenal gland and the fatty capsule of the kidney.