Digital three-dimensional anatomy of abdominopelvic ureter and adjacent structures

doi:10.13418/j.issn.1001-165x.2019.04.006

Chinese Journal of Clinical Anatomy ›› 2019, Vol. 37 ›› Issue (4) : 386-389. DOI: 10.13418/j.issn.1001-165x.2019.04.006

ZHENG Li-mei¹, YU Hong-rong², XU Xiao-wu³, PAN Zhi-yue³, LI Yan-bing¹, HUANG Wen-hua¹

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Abstract

Objective　To provide the anatomic basis for ureteral dissociation in radical hysterectomy by studying the anatomical characters of ureter in abdominopelvic cavity.　Methods　The CTA data of 65 female pelvic patients were collected from Apr.2017 to Dec.2018. Through the 3D reconstruction with ureters, pelvic artery and uterus, the pathway of abdominopelvic ureters was observed. We measured the distance from the ureter to the pelvic artery and the ureter to uterus, then observed the adjacent structures around ureters. Results　There were three types of the iliac artery across the ureter. On the left side, the common iliac artery (33.84%), the bifurcation of common iliac artery (13.85%) and the external iliac vein (55.38%) crossed with the ureter; on the right side, the common iliac artery (27.69%) the bifurcation of the common iliac artery (20.00%), and the external iliac vein (52.30%) crossed with the ureter. The entrance of the “ureteric tunnel” corresponded to the cervix (66.15%) and the entrance of the ureter into the bladder corresponded to the vagina (70.7%). The distance between the bifurcation of the abdominal aorta and the ureter was (32.45±6.24) mm on the left and (39.3±5.78) mm on the right. The distance between the bifurcation of the common iliac artery and the ureter was (10.55±4.85) mm on the left and (13.34±5.49) mm on the right. The distance between the ureteric tunnel entrance and the uterine was (16.94±6.83) mm on the left and (18.11±6.53) mm on the right. The distance between the ureter and the lateral margin of the inner cervical was (19.26±7.62) mm on the left and (22.5±7.41) mm on the right. The distance between the ureter and the lateral margin of the external cervical was (17.06±6.19) mm on the left and (22.49±4.94) mm on the right. There were statistical differences between the above mentioned two sides (P<0.05).　Conclusion　These findings provide novel and important references to the anatomic relationship of the ureter in abdominopelvic cavity and adjacent structures. It may help surgeons reduce the risk of ureteric injury in radical hysterectomy.

Key words

Ureter / 3D reconstruction / Abdominal pelvic artery / The cervical segment; Anatomical measurement

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ZHENG Li-mei, YU Hong-rong, XU Xiao-wu, PAN Zhi-yue, LI Yan-bing, HUANG Wen-hua. Digital three-dimensional anatomy of abdominopelvic ureter and adjacent structures[J]. Chinese Journal of Clinical Anatomy. 2019, 37(4): 386-389 https://doi.org/10.13418/j.issn.1001-165x.2019.04.006

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