International Journal of Health and Clinical Research
Yazarlar: Gordhan Ram Choudhary, MK Chabra, Vikas Tomer
Konular:-
Anahtar Kelimeler:Kidney injury,Renal trauma,Conservative.
Özet: Background: The treatment of renal injury is conceivable with either operative approach or nonoperative methodology; in any case, it significantly relies upon the grade of the renal trauma. Various studies have reported that for the treatment of Grades I–III (low-grade) renal trauma, the nonoperative approach is favored over the operative approach. Previous studies have reported that the nonoperative approach had a lower rate of complications associated with the management of Grades I–III (low-grade) renal trauma. Material & Methods: The present prospective observational study was conducted at the Department of Urology at our tertiary care hospital. The study duration was from September 2015 to March 2019. A sample size of 50 was calculated at a 95 % confidence interval at a 10 % acceptable margin of error by epi info software version 7.2. Patients were enrolled from the emergency department and the ward by simple random sampling. Clearance from Institutional Ethics Committee was taken before the start of the study. Written informed consent was taken from each study participant. Results Study included 50 patients with an average age of 38.7 years with 42 patients (84 %) male and 8 patients (16%) female patients with an average BMI of 25.8 kg/m2. On the basis of the side of involvement of renal trauma, right side renal trauma was present in 24 (48%) patients and left side renal trauma was present in 26 (52%) patients. The bilateral injury was not found in any of the study participants. 6 (12%) had Grade I renal trauma, 10 (20%) had Grade II renal trauma, 18 (36%) had Grade III renal trauma, 12 (24%) had Grade IV renal trauma and 4 (8%) had Grade V renal trauma. On the basis of mode of management, 39 (78%) patients had the conservative mode of management, and 11 (22%) patients had an operative mode of management. The mean duration of hospital stay of study participants was 12.2 days. 4 (8%) patients had Double J stenting, 3 (6%) patients had percutaneous drainage of perinephric collection, 1 (2%) patients had exploratory laparotomy with splenectomy and repair of jejunal perforation, 2 (4%) patients had Nephrectomy and 1 (2%) patient had Renorrhaphy. Conclusion: We concluded from the present study that the primary goal in the treatment of renal trauma was to preserve the kidney and conservative management is the standard mode of treatment for all grades of renal trauma. The nonoperative approach is favored over the operative approach because of lower morbidity and mortality rates and lower out-of-pocket expenditure compared to operative management. Patients who were hemodynamically unstable, not responding to conservative measures were managed by operative interventions. Keywords: kidney injury, renal trauma, Conservative.