[The conservative treatment of major kidney injuries]
Autor: | F R, Schmidlin, S, Rohner, K, Hadaya, C E, Iselin, B, Vermeulen, H, Khan, M, Farshad, P, Niederer, P, Graber |
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Jazyk: | francouzština |
Rok vydání: | 1997 |
Předmět: |
Adult
Aged 80 and over Male Adolescent Multiple Trauma Hemodynamics Blood Pressure Middle Aged Kidney Nephrectomy Technetium Tc 99m Mertiatide Hospitalization Radiography Hypertension Renovascular Treatment Outcome Humans Female Longitudinal Studies Prospective Studies Radiopharmaceuticals Radionuclide Imaging Aged Hematuria |
Zdroj: | Annales d'urologie. 31(5) |
ISSN: | 0003-4401 |
Popis: | The choice of treatment (surgical or conservative) for major renal trauma still remains controversial. The objective of this study was to compare the results of patients with major renal trauma (grade III and IV) primarily treated by surgical intervention (1980-1992) with those in patients mainly treated conservatively (1992-1995). Between 1980 and 1995, 83 patients with major renal trauma were hospitalized at our institution. Our results show a higher nephrectomy rate of 44% in the case of primary surgical intervention compared to conservative management (27%). The outcome of twenty-two patients treated conservatively was analyzed prospectively with repeated radiological imaging, blood pressure profiles, and renal function assessment by means of MAG 3 renal scintigraphy. No patient developed renovascular hypertension and the relative function of the traumatized kidney was greater than 40% in 95% of patients. In conclusion, our results confirm a lower nephrectomy rate in the case of conservative management without any increase of the immediate or long-term morbidity. Major renal trauma (grade III, IV) can therefore be effectively treated by conservative management and primary surgical repair is only indicated in patients with hemodynamic instability, persistent hematuria and associated visceral injuries. |
Databáze: | OpenAIRE |
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