Masato Yanagi1, Yukihiro Kondo2, Yuki Endo3, Taiji Nishimura3, Kimiyoshi Mizunuma4, Masatoku Arai5, Hiroyuki Yokota5, Ken Nakazawa6, Satoru Murata6, Sinichiro Kumita6. 1. Department of Urology (Chairman and Professor: Y. Kondo), Nippon Medical School, Tokyo, Japan. s01_093@yahoo.co.jp 2. Department of Urology (Chairman and Professor: Y. Kondo), Nippon Medical School, Tokyo, Japan. 3. Department of Urology (Chief' T. Nishimura), Otawara (Nasu) Red Cross Hospital, Tochigi, Japan. 4. Department of Radiology (Chief: K. Mizunuma), Otawara (Nasu) Red Cross Hospital, Tochigi, Japan. 5. Department of Emergency and Critical Care Medicine (Chairman and Professor: H. Yokota), Nippon Medical School, Tokyo, Japan. 6. Department of Radiology (Chairman and Professor: S. Kumita), Nippon Medical School, Tokyo, Japan.
Abstract
PURPOSE: We evaluated usefulness of transcatheter arterial embolization (TAE) for deep renal injury, and investigated whether there is any difference in outcomes for transcatheter arterial embolization (TAE) performed for deep renal injury in a large-sized hospital (university hospital) in comparison with a middle-sized hospital (local hospital). METHODS: We retrospectively reviewed the outcomes of 42 patients with renal injury who were transported to the critical care center of Nippon Medical School (NMS) Hospital in Tokyo from April 2001 to April 2011 and 33 patients of renal injury transported to the critical care center of Ohtawara Red Cross (ORC) Hospital in Tochigi prefecture from April 2001 to April 2009. Therefore, a total of 75 patients, which is the sum of the patients presenting to both the hospitals for renal injury were reevaluated according to the guidelines developed by the Japanese Association for the Surgery of Trauma (JAST) and published in 2008. RESULTS: Forty-two patients in NMS hospital included 6 women and 36 men who were 16 to 88 years old (mean 41.6), and they were divided into Type I (16), Type II (11), and Type III (15) and were treated with bedrest (30), TAE (7), or laparotomy (5). Five patients died, but no one succumbed solely due to the renal injury. On the other hand, 33 Patients in ORC Hospital included 8 women and 25 men who were 16 to 87 years old (mean 46.6). They were divided into Type I (9). Type II (12), and Type III (12) and were treated with bedrest (24) or TAE (9). Eight patients died, but no one succumbed solely due to the renal injury. Sixteen patients were treated successfully with TAE in the 2 hospitals, and 15 of these 16 patients were divided into type III renal injury. Therefore, we believe that nephrectomy should be avoided in such patients because of the benefits offered by TAE. CONCLUSION: TAE was found to be useful for the treatment of type III renal injury in both institutions, irrespective of the size of a hospital.
PURPOSE: We evaluated usefulness of transcatheter arterial embolization (TAE) for deep renal injury, and investigated whether there is any difference in outcomes for transcatheter arterial embolization (TAE) performed for deep renal injury in a large-sized hospital (university hospital) in comparison with a middle-sized hospital (local hospital). METHODS: We retrospectively reviewed the outcomes of 42 patients with renal injury who were transported to the critical care center of Nippon Medical School (NMS) Hospital in Tokyo from April 2001 to April 2011 and 33 patients of renal injury transported to the critical care center of Ohtawara Red Cross (ORC) Hospital in Tochigi prefecture from April 2001 to April 2009. Therefore, a total of 75 patients, which is the sum of the patients presenting to both the hospitals for renal injury were reevaluated according to the guidelines developed by the Japanese Association for the Surgery of Trauma (JAST) and published in 2008. RESULTS: Forty-two patients in NMS hospital included 6 women and 36 men who were 16 to 88 years old (mean 41.6), and they were divided into Type I (16), Type II (11), and Type III (15) and were treated with bedrest (30), TAE (7), or laparotomy (5). Five patients died, but no one succumbed solely due to the renal injury. On the other hand, 33 Patients in ORC Hospital included 8 women and 25 men who were 16 to 87 years old (mean 46.6). They were divided into Type I (9). Type II (12), and Type III (12) and were treated with bedrest (24) or TAE (9). Eight patients died, but no one succumbed solely due to the renal injury. Sixteen patients were treated successfully with TAE in the 2 hospitals, and 15 of these 16 patients were divided into type III renal injury. Therefore, we believe that nephrectomy should be avoided in such patients because of the benefits offered by TAE. CONCLUSION:TAE was found to be useful for the treatment of type III renal injury in both institutions, irrespective of the size of a hospital.