Dynamics of indicator liver enzymes with regard to operation type in experimental kidney trauma

Musatov O.V., Zurnadzhan S.A., Kohanov A.V.

Kidney ruptures are staying at the third place with regard to frequency in patients with close abdominal trauma in modern surgery and at the first / second place, when all urogenital traumas are taken together. Therefore their treatment with organ-preservation modalities is an actual problem for surgeons and urologists.

This study was performed on 89 chinchilla rabbits and included the investigation of 3 different operations for the kidney rupture management – autoplasty using serous-muscular stomach (greater curvature) flap with vascular pedicle (45 animals), autoplasty using major omentus (17 animals) and nephrectomy (17 animals) – with regard to the dynamics of the indicator enzymes in serum – alanine aminotransferase, aspartate aminotransferase, gammaglutamyl transpeptidase and hepatic lactate dehydrogenase. Control group included 10 intact animals. The observation period was from 1 to 360 days.

It was showed, that using the stomach autotransplant for renal wound plastic led to more quick normalization of the investigated enzymes, which was associated with a productive course of the inflammatory / reparatory processes in affected renal parenchyma. In case of using the fragment of the major omentus a late normalization of the levels of these enzymes was evident with high serum levels in the distant period, which was bound to the chronization of the inflammatory / reparatory processes in the area of renal rapture. After nephrectomy the activity of the enzymes showed the highest levels during 5 first days with a further slow decrease and normalization late in the course of experiment. Comparative assessment of the enzymes’ dynamics allowed to make a conclusion that plastic operation using the serous-muscular greater stomach curvature flap with a vascular pedicle is advantageous to the plastic using major omentus and also that organ-preservation operations are more favorable than nephrectomy.

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