Chaiyut Thanapaisal1, Wichien Sirithanaphol2. 1. Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand. Chaiyut06@yahoo.com 2. Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand.
Abstract
BACKGROUND: Renal trauma is the most common injury in the urogenital system. In the last decade the management has beer shifted f rom a mandatory exploration to conservative treatment. So, the present study was conducted to evaluate the result f, renal trauma patients. MATERIAL AND METHOD: The data of renal trauma patients treated at Srinagarind Hospital since 1 January 1998 to 31 December 2007 was collected. Clinical data and trauma score were obtained via medical record review. RESULTS: Sixty-nine patients were included; 59 were male (82%). Mean age was 29.8 years (1-68 years). Forty-nine patiens: (80%) were injured by traffic accident. Eighteen percents of patients also had splenic injury. Fifty-five patients (80%) of blunt renal injury patients were treated by Non-Operative Management (NOM). In this group, most patients had grade I injury (39%). Mean injury severity score (ISS), revised trauma score (RTS), trauma and injury severity score (TRISS) were 20, 7.3 and 0.93, respectively. Successful rate of non-operative management was 87.2%. Mean hospital stay was 11.8 days and urinary tract infection was the most frequent complication (10%). Fourteen patients (20%) underwent surgery. Mean ISS, RTS, TRISS were 20.8, 5.5, and 0.72, respectively. In the operative group, 71% were grade 5 injury and almost all were treated by nephrectomy. Mean hospital stay was 9 days. CONCLUSION: Blunt injury is the major cause of renal trauma and the main mechanism is traffic accident. The success rate of Non-Operative Management in Srinagarind Hospital was high. However operative management is still the standard treatment in unstable patients.
BACKGROUND:Renal trauma is the most common injury in the urogenital system. In the last decade the management has beer shifted f rom a mandatory exploration to conservative treatment. So, the present study was conducted to evaluate the result f, renal traumapatients. MATERIAL AND METHOD: The data of renal traumapatients treated at Srinagarind Hospital since 1 January 1998 to 31 December 2007 was collected. Clinical data and trauma score were obtained via medical record review. RESULTS: Sixty-nine patients were included; 59 were male (82%). Mean age was 29.8 years (1-68 years). Forty-nine patiens: (80%) were injured by traffic accident. Eighteen percents of patients also had splenic injury. Fifty-five patients (80%) of blunt renal injurypatients were treated by Non-Operative Management (NOM). In this group, most patients had grade I injury (39%). Mean injury severity score (ISS), revised trauma score (RTS), trauma and injury severity score (TRISS) were 20, 7.3 and 0.93, respectively. Successful rate of non-operative management was 87.2%. Mean hospital stay was 11.8 days and urinary tract infection was the most frequent complication (10%). Fourteen patients (20%) underwent surgery. Mean ISS, RTS, TRISS were 20.8, 5.5, and 0.72, respectively. In the operative group, 71% were grade 5 injury and almost all were treated by nephrectomy. Mean hospital stay was 9 days. CONCLUSION: Blunt injury is the major cause of renal trauma and the main mechanism is traffic accident. The success rate of Non-Operative Management in Srinagarind Hospital was high. However operative management is still the standard treatment in unstable patients.