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In addition, a significant number of periaortic nodal metastases occur above the inferior mesenteric artery and in the absence of pelvic node involvement.
8,9) Normal paraganglionic tissue has also been described at the root of the inferior mesenteric artery, which serves as the superior limit of the organ of Zuckerkandl.
18] In a study comparing 2 well-matched cohorts in terms of comorbidities of 46 patients each, no differences were observed in early complication, perioperative mortality and blood transfusion requirement rates between those who underwent extended LND up to the level of the inferior mesenteric artery and those who underwent standard dissection.
For para-aortic lymphadenec-tomies in which node dissection will extend up to the inferior mesenteric artery, the trocar positioning is the same as for pelvic lymphadenectomy.
The area known as the organ of Zuckerkandl (aorticosympathetic group) encompasses all extra-adrenal chromaffin tissue near the origin of the inferior mesenteric artery and the aortic bifurcation.
Postoperatively, patient underwent contrast enhanced angiography, which revealed 60%-70% stenosis of proximal superior mesenteric artery and 80-90% thrombotic occlusion of proximal inferior mesenteric artery with complete thrombotic occlusion of left common iliac artery (Figure 2 and Figure 3).
However, whether it is also vital in discriminating functional significance of renal artery and inferior mesenteric artery (IMA) stenosis remains to be elucidated.
The horseshoe kidney is usually lower than normal because the inferior mesenteric artery limits its ascent.

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