Verletzungen der Niere

Lutzeyer, W.

doi:10.1007/978-3-642-80573-8_1

Cited by 4 publications

(17 citation statements)

References 198 publications

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“…Some authors do not attach crucial importance to a differentiated classification [2,17,19]. However, it is of therapeutic relevance for many cli nicians, since blunt injuries are very often treated conser vatively, whereas perforating injuries are more frequently treated surgically [2,4,6,19,24], In contrast to blunt trauma, which indirectly involves the entire kidney, per forating stab or gunshot injuries which directly affect the organ often have a different action pattern. They can hence only be compared with difficulty and should there fore be classified separately from each other, as has increasingly been done in recent papers [2,6,22,29],…”

Section: Discussionmentioning

confidence: 99%

“…These are: ( 1 ) differences in the trauma genesis (traffic, work, sport, criminal activity); (2) differences in trauma diagnostics (sonography, urography, computer to mography, angiography); (3) differences in trauma man agement (surgery, urology), and (4) differences in trauma evaluation (classification of the degrees of severity of [2][3][4][5][6] Results A total of 24 classifications published from 1896 or between 1950 and 1991 was evaluated (table 1). Of these, 13 (54.2%) did not contain any distinction between blunt and perforating injuries, 9 (37.5%) related exclusively to blunt injuries and only two (8.3%) solely to perforating injuries.…”

Section: Introductionmentioning

confidence: 99%

“…At least seven and at most 20 criteria were not considered on Numerous classifications for renal injuries have been presented in the literature in the past 50 years. These are oriented to different criteria such as: (1) the pathogenesis (closed or open injury); (2) the morphological findings (type and degree of ruptures), and (3) the clinical course (nature and time course of symptoms) [2,3,.…”

Section: Introductionmentioning

confidence: 99%

“…In par ticular the therapeutic measures (conservative or surgical) with which the best results can be obtained in penetrating injuries, 'moderate severe' parenchymal ruptures or ob structive vascular lesions are subject to dispute. The prin cipal parameters for this are on the one hand the percent age of kidneys saved (40-80%), and on the other hand the frequency of persistent complications (3-40%) [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, late complications such as ischemic renal atrophy (4-40%), arterial hyper tension (0.7-33%) and hydronephrotic nephrolithiasis (3-4%) occur very much more frequently after conserva tive treatment (20-40%) than after surgical treatment (1-10%). In the clarification of these discrepancies, the lack of comparability of studies carried out up to now proves to be a crucial obstacle [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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What Classification Is Appropriate in Renal Trauma?

Lent¹

1996

Eur Urol

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

What Classification Is Appropriate in Renal Trauma?

Lent¹

1996

Eur Urol

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Clinical Classification of Renal Injuries

Lent

2003

European Journal of Trauma

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Purpose: To assess whether previous classifications of renal injuries fulfill their purpose and to propose an alternative classification scheme. Material and Methods: In a retrospective analysis, papers that were published in the last 50 years and provided information on pathogenesis, localization, classification, treatment, and monitoring of the progress of renal injuries were evaluated with respect to the number or the frequency of severity grades and parenchymal ruptures, primary and secondary operations or nephrectomies, and early and late complications. Results: 24 papers were evaluated. These showed marked heterogeneity of all basal data and target parameters. The number of cases ranged from 40 to 510, the control periods from 5 to 29 years. The proportion of ruptures ranged from 11.2% to 100%, the percentage of cases treated operatively from 6.5% to 100%, of cases treated conservatively from 0 to 95.29%, of nephrectomies from 3.53% to 19.0%, and the rate of late sequelae/complications from 5.03% to 47.14%. There were seven classifications used with different frequencies, rankings, and criteria. In most of these, the morphologic injuries to the renal parenchyma were graded. The injuries to the renal pelvis-calyx system and the pedicle vessels were assigned without differentiation to a higher degree of severity. The prognostic and therapeutically decisive effects of the respective injuries -bleeding, urine extravasation, disorders of renal functionwere not taken into account at all. Conclusions: Previous classifications of renal injuries are based on anatomic changes without regard to their clinical consequences and degrees of severity. In the new classification scheme presented here, the injured organ systems (parenchyma, collecting system, pedicle vessels) and the existing symptoms of injury (bleeding, urine extravasation, disorders of renal function) are classified according to severity (slight, moderate, severe). Every injury can be defined using a simplified trauma formula (A B C -I II III) that expresses the severity, is relevant to decision-making, and provides advantages for practical emergencies and scientific comparisons.

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Diagnosis and treatment of renal traumas

Carl

1997

Der Urologe A

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A dynamic helical CT scan following initial ultrasound provides reliable radiological staging for kidney traumas and immediate diagnosis of most abdominal injuries. It also proves useful for pediatric traumas. Using mainly CT data we apply a classification system proposed by the American Association for Surgery of Trauma (grade I-V). The diagnostic steps and subsequent management are demonstrated by flow-chart. Most renal traumas may be treated conservatively but persistent bleeding or persistent urinary extravasation may necessitate surgical intervention. In cases of exploration of the kidney, the use of fibrin adhesive, alloplastic mesh capsule and DJ stents enables the reconstruction of the kidney. Exploration of the renal injury should never be omitted if urgent laparotomy is indicated for associated injuries.

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Verletzungen der Niere

Cited by 4 publications

References 198 publications

What Classification Is Appropriate in Renal Trauma?

What Classification Is Appropriate in Renal Trauma?

Clinical Classification of Renal Injuries

Diagnosis and treatment of renal traumas

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