Blunt and penetrating renal injuries: 18-year experience
[ X ]
Tarih
2009
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Aves
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objective: We evaluated patients who were treated for renal injuries. Materials and methods: A total of 203 patients (168 males, 35 females; mean age 31 +/- 9 years) who underwent treatment for renal injuries between January 1990 and August 2008 were evaluated with respect to etiology, diagnostic methods, the severity of injury, accompanying organ injuries, treatment, and complications. Renal injuries were graded according to the severity scale of the American Association for the Surgery of Trauma. Results: Penetrating injuries accounted for 60.1% (n= 122), and blunt trauma accounted for 39.4% (n= 80), while one patient had both. The majority of penetrating injuries were gunshot wounds (69.7%). Six patients (3%) had bilateral renal injury. Time to presentation ranged from 20 minutes to 10 days (mean 113 min). Emergency laparotomy was performed in 117 patients ((57.6%). Radiological investigation was made in 86 patients (42.4%), of whom 22 patients underwent laparotomy due to hemodynamic deterioration, and 64 patients (31.5%) were treated conservatively for grade I to III injuries (46, 15, and 3 patients, respectively). Isolated renal injury was seen in 74 patients (55 blunt, 19 penetrating), while 129 patients (63.6%) had accompanying intra-abdominal and 72 patients had extra-abdominal injuries. A total of 140 renal procedures were performed in 139 patients, including nephrorrhaphy (n= 54), partial nephrectomy (n= 5), nephrectomy (n= 74), and renal artery repair (n= 1). No renal pathology was detected in four patients (2.9%) and only a double J stent was placed in two patients. Perioperative mortality occurred in five patients (2.5%). The overall mortality rate was 16.8% (n= 34). The mean transfusion requirements were 3.4 +/- 0.8 units and 2.3 +/- 0.6 units, and the mean hospitalization times were 9.2 +/- 3.5 days and 13 +/- 2 days in patients treated surgically and conservatively, respectively. Conclusion: Nonoperative management of renal trauma in hemodynamically stable patients preserves renal function and reduces nephrectomy rates.
Açıklama
Anahtar Kelimeler
Kidney/Injuries/Therapy, Nephrectomy
Kaynak
Turkish Journal of Urology
WoS Q Değeri
N/A
Scopus Q Değeri
Q3
Cilt
35
Sayı
1
