Renal travmalara klinik yaklaşımımız: 8 Yıllık deneyim

Year 2016, Volume: 11 Issue: 1, 30 - 33, 01.01.2016

Feyzi Arda Atar İsmail Evren Kamil Gökhan Şeker Emre Şam Volkan Tuğcu Mithat Ekşi Sadi Konuk Eah

Abstract

Amaç: Bu çalışmamızda böbrek yaralanması olan hastalara klinik yaklaşımımızı değerlendirmeyi hedefledik.Gereç ve Yöntem: 2005-2013 yılları arasında renal travma tanısı ile takip edilen 135 hastanın verileri retrospektif olarak değerlendirildi.Bulgular: Yaş ortalaması 29,5 olarak tespit edildi. Etyolojik olarak incelendiğinde %42 hasta penetran, %58 hasta künt ve ting trauma, %58 patients had blunt trauma and %1 hasta iatrojenik yaralanma ile başvurdu. %1 patients had iatrogenic trauma. According to Travmaların AAST Organ Yaralanma Skalası’na göre dağılım yüzdeleri Grade 1-2-3-4-5 yaralanmalar için sırasıyla 11, 13, 26, 35, 13 olarak saptandı. Hastaların %86’sı konservatif olarak tively. Conservative treatment was performed takip edildi.for 86% of the patients. Sonuç: Renal travma ile başvuran özellikle hemodinamik olarak stabil hastalarda organ yaralanma seviyesine bakılmaksızın konservatif tedavi yöntemleri denenmelidir

Keywords

konservatif tedavi , nefrektomi , renal travma

Our clinical approach to renal trauma: Eight years experience

Abstract

Objective: We aimed to evaluate our clinical approach in patients with renal trauma. Material and Methods: Between 2005- 2013, one hundred thirty five patient’s data who presented with renal trauma, were analyzed retrospectively. Results: The mean age was 29.5. When etiologically evaluated %42 of patients had penetrating trauma, %58 patients had blunt trauma and %1 patients had iatrogenic trauma. According to American Association of Trauma Surgery Organ Injury Scale; 11, 13, 26, 35, 13 percent of patients presented with Grade 1-2-3-4-5 injuries respectively. Conservative treatment was performed for 86% of the patients. Conclusion: Conservative managements should be tried without considering the level of trauma especially for hemodynamically stabile patients who presented with renal trauma.

Keywords

Conservative management , nephrectomy , renal trauma

References

• Bent C, Iyngkaran T, Power N et al. Urological injuries fol- lowing trauma. Clin Radiol 2008; 63: 1361–71.
• Djakovic N, Plas E, Martínez-Piñeiro L et al. Guidelines on UrologicalTrauma. Eur Urol 2005; 47: 1–15.
• Bjurlin MA1, Goble SM, Fantus RJ, Hollowell CM Out- comes in geriatric genitourinary trauma . J Am Coll Surg 2011 ;213:415-21.
• Paparel P1, N’Diaye A, Laumon B et all. The epidemiology of trauma of the genitourinary system after traffic acci- dents: analysis of a register of over 43,000 victims. BJU Int 2006;97:338-41.
• Baverstock R, Simons R, McLoughlin M. Severe blunt re- nal trauma: a 7-year retrospective review from a provincial trauma centre. Can J Urol 2001; 8:1372– 6.
• Kawashima A, Sandler CM, Corl FM, et al. Imaging of renal trauma: a comprehensive review. Radiographics 2001;21: 557-574.
• Moore EE, Shackford SR, Pachter HL, et al. Organ injury- scaling: spleen, liver, and kidney. J Trauma 1989; 29: 1664- 1666.
• Lanchon C, Fiard G, Arnoux V, et al. .High Grade Blunt Renal Trauma: Predictors of Surgery and Long-Term Out- comes of Conservative Management. A Prospective Single Center Study. J Urol 2016;195:106-11.
• Santucci RA, McAninch JM. Grade IV renal injuries: eva- luation, treatment, and outcome. World J Surg 2001; 25: 1565-1572.
• D.J. Summerton (Chair), N. Djakovic, N.D. Kitrey et all. Guidelines on Urological Trauma 2015.
• Santucci RA, Wessells H, Bartsch G et all. Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee. BJU Int 2004; 93: 937–54.
• Heyns CF. Renal trauma: indications for imaging and sur- gical exploration. BJU Int 2004; 93: 1165–70.
• Shoobridge, Matthew F. Bultitude*, Jim Koukounaras et all. A 9-year experience of renal injury at an Australian le- vel 1 trauma centre Jennifer J. BJU Int 2013; 112: 2: 53–60.
• Dugi DD 3rd, Morey AF, Gupta A et al: American Associ- ation for the Surgery of Trauma grade 4 renal injury subs- tratification into grades 4a (low risk) and 4b (high risk). J Urol 2010; 183: 592.
• Miranda J. Hardee, William Lowrance, William O. Brant et all. High Grade Renal Injuries: Application of Parkland Hospital Predictors of Intervention for Renal Hemorrhage, The Journal Of Urology Vol 2013;189;1771-1776.
• John B Malcolm1* , Ithaar H Derweesh13** , Reza Mehra- zin1 et all. , Non operative management of blunt renal tra- uma: Is routine early follow-up imaging necessary? BMC Urology 2008, 8:11.
• Lebech A, Strange-Vognsen HH. Hypertension following blunt kidney injury. UgeskrLaeger 1990; 152: 994-997.
• Wang KT, Hou CJ, Hsieh JJ, Chou YS, Tsai CH. Late deve- lopment of renal arteriovenous fistula following gunshot trauma-a case report. Angiology 1998; 49: 415-418.
• Miller DC, Forauer A, Faerber GJ. Successful angioembo- lisation of renal artery pseudoaneurysms after blunt abdo- minal trauma, Urology 2002 ; 59:444.