Long-term results of conservative and surgical management of blunt renal lacerations.

In the management of renal lacerations most attention has centered on surgical or non-surgical treatment and little attention has been given to the long-term results. We have evaluated the medical records and radiographs of 70 patients with blunt renal lacerations; 30 had initial non-surgical management and 40 had initial surgical management. Patients with initial non-surgical management were followed up for an average of 40.4 months. Normal blood pressure and/or radiological evaluation of the kidney were noted in 22% of those who had non-surgical management (hypertension in 55%) and in 75% of those who had delayed renal surgery (hypertension in 29%). Patients with immediate surgical management were followed up for an average of 49.6 months and normal blood pressure and/or radiological evaluation of the kidney were present in 83% (no hypertension). On long-term follow-up, patients with non-surgical management had a much higher rate of hypertension and/or abnormal radiological evaluation of the kidney than those with immediate surgical management.