ABSTRACT
Nephrectomy The nephrectomy rate for immediate exploration of major renal lacerations varies depending on the type and severity of the trauma and hemodynamic instability. Penetrating mechanism, high-velocity weapons, and multiple injuries are associated with a higher nephrectomy rate.(2-5)
In one series (14), 69 of 87 renal injuries were surgically explored (79.3%), and 12 patients underwent nephrectomy (13.8%). Forty-six (66.6%) renal units were reconstructed by various methods, including renorrhaphy, omental pedicle flaps, mesh or peritoneal patch grafts, partial nephrectomy, and vascular repair. The overall renal salvage was 86.2%. Early renal vascular control was achieved in all patients who underwent renal exploration. These findings suggest that early vascular control and careful selection of reconstructive techniques can ensure a high renal salvage rate in patients with high-grade renal gunshot injuries.
