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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