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Objective: Kidney repair reconstruction techniques are controversial. The conventional technique is suturing, but this is usually with further loss of viable tissue as it promotes scaring. In this animal model, we investigated the parenchymal effect of different sutures and methods., Methods: We carried out this study in the year 2000 in the Animal Laboratory of Dicle University, Diyarbakir, Turkey. We used 40 New Zealand white rabbits in this study, randomized into 5 groups. We separated the left kidney from Gerota's fascia, and performed standard lacerations with incisions 5 mm deep and 10 mm in length. We performed no reconstruction procedure in group 1, and used homeostatic collagen powder in group 2. We primarily sutured the lacerations with chromic gut (4/0) in group 3, and sutured the kidney in group 4 with polyglactin (4/0). We wrapped the kidney with a polyglactin mesh in group 5. We sacrificed 2 rabbits in each group postoperatively on day 2, 15, 45 and 90, and performed left nephrectomy for histological investigation, and assessed interstitial inflammation., Results: While group 5 established the best results, the other 4 groups had similar intermediate results. The pseudocapsule was visible macroscopically in the polyglactin mesh group. We could see mononuclear cell infiltration, dilatation of tubules, atrophy of tubules, and interstitial fibrosis in all groups except group 5., Conclusion: In this animal model, we found that the most appropriate repair material for kidney surgery was polyglactin mesh.

Background: We review our trauma cases over the last 11 years and discuss our diagnosis and treatment modalities., Methods: One hundred and thirty-five patients with renal injuries who had been hospitalized in the Urology and General Surgery clinics of Dicle University hospital between 1990 and 2001 were reviewed retrospectively. Patients were evaluated with regard to age, sex, cause of trauma, transport time, diagnostic methods, grade of injuries, associated organ injuries, treatments and complications., Results: One hundred and forty-one renal injuries were established in 135 patients. The patients were between 5 and 65 years old; 114 (84.4%) were male and 21 (15.6%) were female. The most common cause of injuries (99 patients) was penetrating injuries. The transport time to hospital after injury was approximately 116 min. Immediate laparotomy was performed in 95 hemodynamically unstable patients. Radiological investigations were carried out in the remaining 40 patients. Most of the injuries were grade 4 (28, 19.86%) or 5 (60, 42.55%). Isolated renal injury was established in only 22 of 135 patients. Nephrorrhaphy was performed in 45 of 141 kidneys. Twelve injured kidneys were managed conservatively. Nephrectomy was performed in 66 of 141 kidneys. The remaining injured kidneys were managed with different treatment methods. Twenty-nine (21.48%) patients were lost intraoperatively or during the early postoperative period., Conclusion: We believe that our rates of nephrectomy and mortality were high because of the long transport time, unsuitable transport type, frequent high grade and high rate of associated organ injuries.

Objective: This prospective study was performed to determine whether extracorporeal shock-wave lithotripsy (ESWL), widely used for treating renal and ureteral stones, affects the kidney interlobar artery resistive index (RI)., Material and Methods: A total of 43 patients (30 with renal and 13 with ureteral stones) underwent color Doppler examination before and 30 min and 3 h after ESWL. Seventeen patients with renal and nine with ureteral stones underwent Doppler examination 2 weeks later. Measurements were made near the stones (nearby region), at least 2 cm from the stones (remote region) and in the contralateral kidney for renal stones, and in the ipsilateral and contralateral kidneys for ureteral stones., Results: In patients with renal stones, the RI was increased 30 min and 3 h after ESWL in the nearby and remote regions, and more markedly in the former. In the contralateral kidney, there was an increase in RI only at 3 h, which was less than that in the ipsilateral kidney. The RI at 2 weeks post-ESWL in the nearby region and contralateral kidney did not differ from the pre-ESWL values. ESWL performed for ureteral stones caused no increase in RI in the ipsilateral kidney., Conclusion: Patients with renal stones had a temporary increase in RI in the hours following ESWL in both the ipsilateral and contralateral kidneys, which was highest in the region near the stones and lowest in the contralateral kidney. Two weeks later, the RI in both areas had returned to pre-ESWL levels.