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Penetrating renovascular trauma
R R Ivatury1, R Zubowski, W M Stahl
1Department of Surgery, New York Medical College, Bronx, New York.
The Journal of Trauma
|December 1, 1989
Summary
Nephrectomy remains the primary treatment for renovascular injuries, with outcomes largely determined by associated trauma. Renal salvage is limited, particularly for artery injuries, while vein injuries show a better prognosis.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Urology
Background:
- Renovascular injuries present significant management challenges.
- Associated trauma often dictates patient prognosis and kidney survival.
Purpose of the Study:
- To evaluate the outcomes of renovascular injuries over a 10-year period.
- To assess the efficacy of different management strategies, including nephrectomy and repair.
Main Methods:
- Retrospective review of 39 patients with 40 renovascular injuries.
- Analysis of mortality rates, surgical interventions (nephrectomy, repair, ligation), and renal salvage rates.
Main Results:
- Overall mortality was 30%, primarily due to associated trauma.
- Nephrectomy was performed in 51% of patients.
- Renal salvage was achieved in 23% of cases; higher for isolated renal vein injuries (43.6%) than artery injuries (33%).
Conclusions:
- Nephrectomy is often the most expeditious management for renovascular trauma.
- Successful renal artery repair is uncommon.
- Renal vein injuries have a more favorable prognosis for salvage.