A Comparative Study of Conservation, Endovascular Embolization Therapy, and Surgery for Blunt Renal Trauma
- 29 April 2020
- journal article
- research article
- Published by International Scientific Information, Inc. in Medical Science Monitor
- Vol. 26, e922802-1-e922802-8
- https://doi.org/10.12659/msm.922802
Abstract
Background: In this study, we evaluated the advantages and disadvantages of angioembolization in patients with Grade III-V blunt renal trauma compared with other treatments. Material/Methods: We prospectively collected data on patients hospitalized for Grade III-V blunt renal trauma. Organ damage was graded according to the American Association for the Surgery of Trauma (AAST) criteria. Initial grouping was then performed according to the hemodynamics and "initial treatment". The eligible patients were divided into 3 groups: conservative treatment group (Group A), arterial embolization group (Group B), and surgical group (Group C). The success rate, significance, and follow-up renal function were evaluated. Results: In Group B of Grade IV, estimated glomerular filtration rate (eGFR) and serum creatinine (Scr) levels were slightly decreased and increased, respectively, after embolization compared with before embolization (P=0.002, P=0.039). In Grade V, the eGFR of Group B after embolization was lower than before embolization (P=0.041); The levels of serum urea (Urea) and Scr in Group B after treatment were higher than those before treatment (P=0.042, P=0.024). Conservative treatment and angioembolization were better than exploration in protecting renal function of Grade IV (P=0.035 and P=0.047, respectively). Conclusions: The success rate of angioembolization was high and protected renal function to the greatest extent, and there were no differences in renal function at long-term follow-up. However, it is difficult to manage renal vessel laceration or avulsion by embolization alone, and various endovascular therapies are required to protect the function of residual kidneys.Keywords
This publication has 24 references indexed in Scilit:
- Computed tomographic imaging in determining the need of embolization for high-grade blunt renal injuryThe Journal of Trauma and Acute Care Surgery, 2013
- Long-Term Renal Function Assessment With Dimercapto-Succinic Acid Scintigraphy After Conservative Treatment of Major Renal TraumaJournal of Urology, 2012
- Indications and relative renal function for paediatric nephrectomy over a 20-year periodPediatric Surgery International, 2011
- Comparison of Nonoperative Management With Renorrhaphy and Nephrectomy in Penetrating Renal InjuriesThe Journal of Trauma and Acute Care Surgery, 2011
- What Are the Specific Computed Tomography Scan Criteria That Can Predict or Exclude the Need for Renal Angioembolization After High-Grade Renal Trauma in a Conservative Management Strategy?The Journal of Trauma and Acute Care Surgery, 2011
- Evaluation of Renal Function After Major Renal Injury: Correlation With the American Association for the Surgery of Trauma Injury ScaleJournal of Urology, 2010
- Selective Management of Isolated and Nonisolated Grade IV Renal InjuriesJournal of Urology, 2006
- EAU Guidelines on Urological TraumaEuropean Urology, 2005
- Evaluation and management of renal injuries: consensus statement of the renal trauma subcommitteeBJU International, 2004
- Use of Ureteral Stents in the Management of Major Renal Trauma with Urinary Extravasation: Is There a Role?Journal of Endourology, 1998