Non-Surgical Strategies for High-Grade Renal Injury: A Retrospective Study in A Tertiary Care Centre

K Muthurathinam; V Kumaraguru; G Arunchander; Rahul Narayanan Unni

K Muthurathinam Assistant Professor, Department of Urology, Government Royapettah Hospital & Govt, Kilpauk Medical College, Kilpauk, Chennai, India.
V Kumaraguru PG Resident, Government Royapettah Hospital & Govt, Kilpauk Medical College, Kilpauk, Chennai, India.
G Arunchander PG Resident, Government Royapettah Hospital & Govt, Kilpauk Medical College, Kilpauk, Chennai, India.
Rahul Narayanan Unni PG Resident, Government Royapettah Hospital & Govt, Kilpauk Medical College, Kilpauk, Chennai, India.

Keywords: High-Grade Renal Injury, Surgical Exploration, Conservative Management, Non-Operative Approach, Nephrectomy

Abstract

Introduction: Renal injuries account for 1% to 5% of all trauma-related injuries. Recently, the management of blunt renal trauma has increased the preference for non-operative treatment. This study evaluates outcomes of conservative (non-operative) management for high-grade blunt renal injuries at our medical centre.
Materials and Methods: This retrospective study analysed hospital records from the past 6 months, including all patients with blunt renal injuries. Patients were classified by the AAST injury grading system and categorised based on operative or non-operative management. We focused on assessing instances of “non-operative management failure,” complications, and the necessity for additional procedures. Descriptive analysis was conducted using Microsoft Excel software (version 2021).
Results: The study included 14 patients with an average age of 40.6 years. Eleven had Grade I–III injuries, two had Grade IV injuries, and one had a Grade V injury. All patients with Grade I–III injuries were successfully managed conservatively without requiring additional procedures. No immediate surgical explorations were performed. Among the two Grade IV injuries managed non-operatively, one required delayed exploration, while the Grade V injury did not necessitate intervention. Complications included urinary tract infection in one case, persistent haematuria in one case, urinoma in one case, and ileus in two cases. All complications were Clavien grade 1–2, with no mortalities.
Conclusion: Our findings support that when haemodynamically stable, conservative management is viable for high-grade (Grade IV and V) blunt renal injuries. The failure rate of non-operative management was one case for Grade IV injuries and none for Grade V injuries.

How to cite this article:
K Muthurathinam, V Kumaraguru, G arunchander, Unni N R. Non-Surgical Strategies for High-Grade Renal Injury: A Retrospective Study in A Tertiary Care Centre. J Adv Res Med 2024; 11(1): 1-5.

DOI: https://doi.org/10.24321/2349.7181.202401

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