Volume 62, Issue 6, Pages (December 2012)

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Volume 62, Issue 6, Pages 1001-1008 (December 2012) Precise Segmental Renal Artery Clamping Under the Guidance of Dual-source Computed Tomography Angiography During Laparoscopic Partial Nephrectomy Pengfei Shao, Lijun Tang, Pu Li, Yi Xu, Chao Qin, Qiang Cao, Xiaobing Ju, Xiaoxin Meng, Qiang Lv, Jie Li, Wei Zhang, Changjun Yin European Urology Volume 62, Issue 6, Pages 1001-1008 (December 2012) DOI: 10.1016/j.eururo.2012.05.056 Copyright © 2012 European Association of Urology Terms and Conditions

Fig. 1 Three anatomic variants of target branches: (A) extrahilum type, (B) intrahilum type, and (C) mixed type. Top row: sketches of the anatomic variants. Bottom row: correspondent computed tomography angiography. Orange arrow points to the target branch. European Urology 2012 62, 1001-1008DOI: (10.1016/j.eururo.2012.05.056) Copyright © 2012 European Association of Urology Terms and Conditions

Fig. 2 Dissection approach from the posterior hilum. A left-kidney, 3.2-cm-diameter, endophytic tumor located on the posterior side and fed by a single branch. Left top: cross-section of computed tomography (CT) scan. Left bottom: dissection approach from the posterior side. Right top: dual-source CT (DSCT) angiography with three-dimensional reconstruction. Right bottom: DSCT angiography overview from posterior side. Orange arrow points to the target branch, yellow arrow points to the presegmental artery/stem of target branch. European Urology 2012 62, 1001-1008DOI: (10.1016/j.eururo.2012.05.056) Copyright © 2012 European Association of Urology Terms and Conditions

Fig. 3 Dissection approach from the anterior hilum. A right-kidney, 3.8-cm-diameter, mesophytic tumor located on the anterior side and fed by two branches. Left top: cross-section of computed tomography (CT) scan. Left bottom: dissection approach from the anterior hilum. Right top: dual-source CT (DSCT) angiography with three-dimensional reconstruction. Right bottom: DSCT angiography overview from the anterior side. Orange arrow points to the target branch, yellow arrow points to the presegmental artery/stem of target branch. European Urology 2012 62, 1001-1008DOI: (10.1016/j.eururo.2012.05.056) Copyright © 2012 European Association of Urology Terms and Conditions

Fig. 4 Dissection approach from both anterior and posterior hila. A left-kidney, 5.5-cm-diameter, mesophytic tumor striding both anterior and posterior sides and fed by two branches. Left top: cross-section of computed tomography (CT) scan. Left middle: dissection approach from the posterior hilum. Left bottom: dissection approach from the anterior hilum. Right top: Dual-source CT (DSCT) angiography with three-dimensional reconstruction. Right middle: DSCT angiography overview from posterior side. Right bottom: DSCT angiography overview from the anterior side. Orange arrow points to the target branch, yellow arrow points to the presegmental artery/stem of target branch. European Urology 2012 62, 1001-1008DOI: (10.1016/j.eururo.2012.05.056) Copyright © 2012 European Association of Urology Terms and Conditions

Fig. 5 Excision of the tumor, maximally preserving the normal parenchyma. Left: the tumor was excised closely around its pseudocapsule, leaving a 1- to 2-mm margin of normal parenchyma. Right: The artery feeding normal parenchyma was peeled off the pseudocapsule to preserve the blood supply to adjacent parenchyma. European Urology 2012 62, 1001-1008DOI: (10.1016/j.eururo.2012.05.056) Copyright © 2012 European Association of Urology Terms and Conditions