ISSN: 1859 - 2872
Evaluation of blunt renal trauma management
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Abstract
Objective: To evaluate of blunt renal trauma management. Subject and method: A retrospective study in 37 patients with blunt renal trauma at 108 Military Central Hospital from October 2014 to June 2018. The patients were divided into two groups: Mild-grade renal trauma (grade 1 - 3) and high-grade renal trauma (grade 4 - 5). Result: The successful rate by conservative treatment was 89.2% (100% in mild and 76.47% in severe group). Nonoperative management was 64.9%, surgery was 18.9%, nephrectomy was 10.8%, angioembolization was 2.7% and insertion of retrograde stent (JJ) was 2.7%. Conclusion: Conservative management for hemodynamically stable patients with blunt reanal trauma was safe with low risk of complications. Management decisions should consider hemodynamic status and visualization of active renal bleeding as well as injury grade in determining operative management.
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References
2. Trần Thanh Phong (2017) Nghiên cứu phương pháp điều trị bảo tồn thận chấn thương độ 4, 5. Tạp chí Y dược học, số đặc biệt, tr. 93-97, 8/2017.
3. Trần Quốc Hòa (2018) Nghiên cứu ứng dụng phẫu thuật nội soi điều trị chấn thương thận. Luận án tiến sĩ, Trường Đại học Y Hà Nội.
4. Alman AL, Haas A, Dinchman KH, Spimak JP (2000) Selective nonoperative management of blunt grade 5 renal injury. J.Urol 164(1): 27-30.
5. Mingoli A, La Torre M, Migliori E (2017) Operative and nonoperative management for renal trauma: Comparison of outcomes. A systematic review and meta-analysis. Therapeutics and Clinical Risk Management Journals 13: 1127-1138.
6. Bryk DJ, Zhao LC (2016) Guideline of guidelines: A review of urological trauma guidelines. BJU Int 117(2): 226-234.
7. Lanchon C, Fiard G (2016) High grade blunt renal trauma: Predictors of surgery and long-term outcomes of conservative management. A prospective single center study. J. Urol 195(1): 106-111.
8. Buckley JC, Macanich JW (2006) Selective management of isolated and nonisolated grade IV renal injuries. J. Urol 176(6): 2498-2502.
9. Hardee MJ, Lowrance W, Brant WO, Person AP, Stevens MH, Myers JB (2013) High grade renal injuries: Application of parkland hospital preditors of intervention for renal hemorrhage. J. Urol 189(5): 1771-1776.
10. Morey AF, Brandes S, Dugi DD (2014) Urotrauma: AUA guideline. J. Urol 192(2): 327-335.
11. Santucci RA, Fisher MB (2005) Literature increasingly supports expectant management of renal trauma- a systematic review. J. Trauma 59(2): 493-503.
12. Wilden GM, Velmahos GC (2013) Successful nonoperative management of the most severe blunt renal injuries. JAMA surg 148(10): 924.
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