KÜNT RENAL YARALANMALARDA YAKLAÞIM

Kliniðimizde Ocak 1992 ile Þubat 1998 tarihleri arasýnda künt batýn travmasýna baðlý renal yaralanma tanýsý konulan 14'ü (%29.16) kadýn, 34'ü (%70.84) erkek toplam 48 hastanýn kayýtlarý retrospektif olarak incelendi Yaralanma þekli bakýmýndan yüksekten düþme 22 hasta (%45.8) ile ilk sýrada yer almaktaydý. Hastalarýn yaþ ortalamasý 27.8 yýldý (minimum 6 - maksimum 71). Hastalarýn 41'inde %85.4 minör, 7 'sinde %14.6 majör renal yaralanma olduðu görüldü. 41'inde minör, 3'ünde majör renal yaralanma olan toplam 44 hastaya, (%91.7) konservatif tedavi uygulanmýþ olup, bunlarýn 43'ü (%97.7) baþarýlý bir þekilde tedavi edilirken, majör yaralanmasý olan bir (%2.3) hasta geç eksplorasyon sonrasý konservatif kalýnarak tedavi edildi. Acil eksplorasyon uygulanan 4 (%8.3) hastada majör renal yaralanma vardý ve bunlarýn 3' üne nefrektomi yapýlýrken kalan bir hastaya konservatif kalýnmasýna karar verildi. Takiplerine devam eden hastalarýn hiçbirinde geç dönem komplikasyonlarý (retroperitoneal apse, ürinom, sepsis) geliþmedi. Genel beden travmalarýnda renal yaralanma oraný %3-10 arasýnda meydana gelmektedir. Son yýllarda renal yaralanmalarýn taný ve tedavisinde önemli geliþmeler olmuþtur. Giderek daha fazla konservatif yaklaþýma doðru artmýþ bir eðilim görülmektedir. Bu geliþmeler doðrultusunda kendi deneyimlerimizi yeniden gözden geçirdik ve bu konuda batýn travmalarýyla ilgili uzmanlýk dallarýnýn deneyimlerini gözden geçirmelerinin gerekli olduðunu gördük.

GENITOURINARY SYSTEM TRAUMAS

The records of total 48 patients (14(29%) female, (34(71%) male); which were interned with the diagnosis of blunt renal trauma between January 1992 and February 1998 were reviewed. According to type of trauma deaccelaration was the most common (22 patients 45.8%). There were 41 patients (85.4%) minor and 7patients (14.6%) with major renal trauma. A total of 44 (91.7%) patients which 41 were minor and three were major treated with coservative methods. Coservative methods were succesfull in 43 (97.7%) patients where as one patient (2.3%) underwent a late exploration. In all of 4 patients who underwent surgical exploration had major renal traumas and 3 of them treated by nephrectomy and in one patient coservative methods were used after the exploration. None of the patients in the follow-up period late complications were seen as retroperiteonal abcess, urinoma and sepsis. Renal traumas are seen at a persentage of 3-10 in general body traumas. In recent years several improvements made in the diagnosis and treatment of renal traumas which gives a common use of conservative methods. Within the lights of these improvements we re-evaluated our experiences and also concluded that the other experts who treats trauma patients must do the same also.