The excretory tract lesions of severe renal trauma were grade IV and V of AAST classification. The study evaluated the results of surgical management of the renal excretory tract lesions. Material and methods. Retrospective and prospective study of 121 severe renal trauma cases treated by surgical management at Viet Duc Hospital from January 2004 to January 2011. Results. 92 males (76 percent) and 50 females (24.2 percent) at the average age of 32.49 + or - 15.51 years old (ranging from 8 to 84). The traffic accident was the main cause in 74.4 percent. Indirect trauma accounted for 16.5 percent and shock was 59.5 percent. 62.8 percent had associated injuries combination. The rate of grade IV renal trauma took up 68.6 percent and grade V was 31.4 percent including complete renal pelvic rupture (4.1 percent) and partial renal pelvic rupture (2.5 percent). The finding of renal lesions on CT scan included early extravasation (19 percent) and late extravasation (49.6 percent). The successful rate of renal conservative surgery was 80.2 percent, in which conservation renorrhaphy rate amounted to 45.5 percent, partial nephrectomy rate was 22.3 percent. The laparoscopic renal conservative surgery was 5.8 percent. The rate of early complication after surgery was 8.3 percent. At the long-term follow-up from 12 - 84 months (averagely 45.41 + or - 23.19 months), 85.6 percent of the total patients were observed without complication and re-operation, in which 91.6 percent of the cases well recovered the renal function. The rate of renal hypofunction long after the surgery was 8.4 percent. Conclusions. The excretory tract lesions of severe renal trauma were the main causes of complications in conservative management. To early diagnose these lesions and find out the best procedure to surgical treatment lead to diminishing the complications and increasing the ability of conservative renal trauma.
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