Development of the Human Retroperitoneal Fasciae
Introduction: Although the renal fascia (RF), ureteral sheath, lateroconal fascia (LF) and hypogastric nerve are critical landmarks for retroperitoneal surgery, their laminar relationships require clarification. Materials and Methods: Horizontal sections (hematoxylin-eosin staining) of human fetuses...
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Published in | Cells, tissues, organs Vol. 190; no. 5; pp. 286 - 296 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Basel, Switzerland
S. Karger AG
01.01.2009
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Abstract | Introduction: Although the renal fascia (RF), ureteral sheath, lateroconal fascia (LF) and hypogastric nerve are critical landmarks for retroperitoneal surgery, their laminar relationships require clarification. Materials and Methods: Horizontal sections (hematoxylin-eosin staining) of human fetuses at two different developmental stages [9–12 (3 fetuses, crown-rump length, CRL 40–65 mm) and 20–25 weeks of gestation (9 fetuses, CRL 152–220 mm)] were compared. Results: In the early-stage group, the pararenal space had already formed between the posterior RF and the transversalis fascia (TF). The anterior RF extended along the peritoneum and often fused with the latter. In the late-stage group, the posterior RF extended inferomedially toward the anterior aspect of the aorta and inferior vena cava. However, at the level of the renal hilus, the posterior RF was connected with vascular sheaths of the great vessels. The LF was seen developing as a fasciculation of the multilaminar structure in the pararenal space. However, on the posterolateral side of the colon after retroperitoneal fixation, the fusion fascia of the peritoneum could also be identified as LF. Conclusions: A common sheath for ureters and hypogastric nerves appeared to be likely on the inferior side of the kidney. The LF did not appear to be a primary structure such as the RF, but a result of secondary mechanical stress due to fatty tissue developing earlier along the TF than in the perirenal space. However, the suggested similarity between LF and fusion fascia in the plane occupied was a likely cause for misinterpreting the laminar configurations during surgery. |
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AbstractList | Introduction: Although the renal fascia (RF), ureteral sheath, lateroconal fascia (LF) and hypogastric nerve are critical landmarks for retroperitoneal surgery, their laminar relationships require clarification. Materials and Methods: Horizontal sections (hematoxylin-eosin staining) of human fetuses at two different developmental stages [9-12 (3 fetuses, crown-rump length, CRL 40-65 mm) and 20-25 weeks of gestation (9 fetuses, CRL 152-220 mm)] were compared. Results: In the early-stage group, the pararenal space had already formed between the posterior RF and the transversalis fascia (TF). The anterior RF extended along the peritoneum and often fused with the latter. In the late-stage group, the posterior RF extended inferomedially toward the anterior aspect of the aorta and inferior vena cava. However, at the level of the renal hilus, the posterior RF was connected with vascular sheaths of the great vessels. The LF was seen developing as a fasciculation of the multilaminar structure in the pararenal space. However, on the posterolateral side of the colon after retroperitoneal fixation, the fusion fascia of the peritoneum could also be identified as LF. Conclusions: A common sheath for ureters and hypogastric nerves appeared to be likely on the inferior side of the kidney. The LF did not appear to be a primary structure such as the RF, but a result of secondary mechanical stress due to fatty tissue developing earlier along the TF than in the perirenal space. However, the suggested similarity between LF and fusion fascia in the plane occupied was a likely cause for misinterpreting the laminar configurations during surgery. Copyright © 2009 S. Karger AG, Basel [PUBLICATION ABSTRACT] Introduction: Although the renal fascia (RF), ureteral sheath, lateroconal fascia (LF) and hypogastric nerve are critical landmarks for retroperitoneal surgery, their laminar relationships require clarification. Materials and Methods: Horizontal sections (hematoxylin-eosin staining) of human fetuses at two different developmental stages [9–12 (3 fetuses, crown-rump length, CRL 40–65 mm) and 20–25 weeks of gestation (9 fetuses, CRL 152–220 mm)] were compared. Results: In the early-stage group, the pararenal space had already formed between the posterior RF and the transversalis fascia (TF). The anterior RF extended along the peritoneum and often fused with the latter. In the late-stage group, the posterior RF extended inferomedially toward the anterior aspect of the aorta and inferior vena cava. However, at the level of the renal hilus, the posterior RF was connected with vascular sheaths of the great vessels. The LF was seen developing as a fasciculation of the multilaminar structure in the pararenal space. However, on the posterolateral side of the colon after retroperitoneal fixation, the fusion fascia of the peritoneum could also be identified as LF. Conclusions: A common sheath for ureters and hypogastric nerves appeared to be likely on the inferior side of the kidney. The LF did not appear to be a primary structure such as the RF, but a result of secondary mechanical stress due to fatty tissue developing earlier along the TF than in the perirenal space. However, the suggested similarity between LF and fusion fascia in the plane occupied was a likely cause for misinterpreting the laminar configurations during surgery. INTRODUCTIONAlthough the renal fascia (RF), ureteral sheath, lateroconal fascia (LF) and hypogastric nerve are critical landmarks for retroperitoneal surgery, their laminar relationships require clarification.MATERIALS AND METHODSHorizontal sections (hematoxylin-eosin staining) of human fetuses at two different developmental stages [9-12 (3 fetuses, crown-rump length, CRL 40-65 mm) and 20-25 weeks of gestation (9 fetuses, CRL 152-220 mm)] were compared.RESULTSIn the early-stage group, the pararenal space had already formed between the posterior RF and the transversalis fascia (TF). The anterior RF extended along the peritoneum and often fused with the latter. In the late-stage group, the posterior RF extended inferomedially toward the anterior aspect of the aorta and inferior vena cava. However, at the level of the renal hilus, the posterior RF was connected with vascular sheaths of the great vessels. The LF was seen developing as a fasciculation of the multilaminar structure in the pararenal space. However, on the posterolateral side of the colon after retroperitoneal fixation, the fusion fascia of the peritoneum could also be identified as LF.CONCLUSIONSA common sheath for ureters and hypogastric nerves appeared to be likely on the inferior side of the kidney. The LF did not appear to be a primary structure such as the RF, but a result of secondary mechanical stress due to fatty tissue developing earlier along the TF than in the perirenal space. However, the suggested similarity between LF and fusion fascia in the plane occupied was a likely cause for misinterpreting the laminar configurations during surgery. Although the renal fascia (RF), ureteral sheath, lateroconal fascia (LF) and hypogastric nerve are critical landmarks for retroperitoneal surgery, their laminar relationships require clarification. Horizontal sections (hematoxylin-eosin staining) of human fetuses at two different developmental stages [9-12 (3 fetuses, crown-rump length, CRL 40-65 mm) and 20-25 weeks of gestation (9 fetuses, CRL 152-220 mm)] were compared. In the early-stage group, the pararenal space had already formed between the posterior RF and the transversalis fascia (TF). The anterior RF extended along the peritoneum and often fused with the latter. In the late-stage group, the posterior RF extended inferomedially toward the anterior aspect of the aorta and inferior vena cava. However, at the level of the renal hilus, the posterior RF was connected with vascular sheaths of the great vessels. The LF was seen developing as a fasciculation of the multilaminar structure in the pararenal space. However, on the posterolateral side of the colon after retroperitoneal fixation, the fusion fascia of the peritoneum could also be identified as LF. A common sheath for ureters and hypogastric nerves appeared to be likely on the inferior side of the kidney. The LF did not appear to be a primary structure such as the RF, but a result of secondary mechanical stress due to fatty tissue developing earlier along the TF than in the perirenal space. However, the suggested similarity between LF and fusion fascia in the plane occupied was a likely cause for misinterpreting the laminar configurations during surgery. |
Author | Niikura, Hitoshi Murakami, Gen Fujimiya, Mineko Matsubara, Akio Kinugasa, Yusuke Usui, Tsuguru |
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Keywords | Hypogastric nerve Renal fascia Lateroconal fascia Ureter Human fetus |
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Snippet | Introduction: Although the renal fascia (RF), ureteral sheath, lateroconal fascia (LF) and hypogastric nerve are critical landmarks for retroperitoneal... Although the renal fascia (RF), ureteral sheath, lateroconal fascia (LF) and hypogastric nerve are critical landmarks for retroperitoneal surgery, their... INTRODUCTIONAlthough the renal fascia (RF), ureteral sheath, lateroconal fascia (LF) and hypogastric nerve are critical landmarks for retroperitoneal surgery,... |
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SubjectTerms | Abdominal Cavity - embryology Aborted Fetus Aorta, Abdominal - embryology Colon - embryology Dissection Fascia - embryology Humans Hypogastric Plexus - embryology Intra-Abdominal Fat - embryology Kidney - embryology Organogenesis - physiology Original Paper Peritoneum - embryology Retroperitoneal Space - embryology Ureter - embryology Vena Cava, Inferior - embryology |
Title | Development of the Human Retroperitoneal Fasciae |
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