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Para-aortic (lumbar) nodes

Local vessels and regional nodes · Retroperitoneal

Nodes flanking the aorta and inferior vena cava from the diaphragm to the bifurcation take the gonads, kidneys, adrenals, ureters and posterior abdominal wall directly, and the pelvis and lower limbs after relay through the iliac chain.

Traced from the start

  1. Testis and ovary
  2. Para-aortic (lumbar) nodes

Detail

Direct drainage
Testis/ovary, kidney, adrenal, ureter, uterine fundus
Gonadal level
L2, with the testicular and ovarian vessels
Indirect drainage
External and common iliac chains from pelvis and lower limb
Efferents
Right and left lumbar trunks

When it goes wrong

Retroperitoneal lymph node dissection for testicular cancer

Sympathetic plexus injury with loss of antegrade ejaculation

Renal cell carcinoma

Para-aortic nodal disease alongside renal vein and caval tumour extension

Practise this structure

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