Conservative or immediate surgical management of Blunt renal injuries

Publisher Website
Google Scholar
Abstract
From 1969-1981, 1176 blunt renal injuries were recorded in 1166 patients (10 patients had bilateral injuries). Conservative management of 27 patients with severe renal injuries resulted in a delayed renal operation in 30% and total renal loss in 22%. A review of the published series of the conservative management of patients with severe renal injuries (laceration, rupture and pedicle injury) shows a renal surgery rate of 13-68%, a renal loss rate of 3-33% and a significant complication/renal surgery rate of 13-76%. In patients with severe renal injuries 88% had associated injuries and 73% of these underwent immediate laparotomy for intraabdominal injury. Immediate renal surgery in 59 patients with severe renal injuries resulted in a nephrectomy rate of 6.5% of 31 renal lacerations, 100% of 14 renal ruptures and 50% of 14 pedicle injuries. Of the 14 patients with pedicle injuries, 6 (43%) had immediate vascular repair, with salvage of the kidney. Immediate surgical management of the patients with severe renal injuries obviated the need for a second exploration in a severely injured patient, reduced morbidity and resulted in increased renal salvage.