Abstract
BackgroundAfter renal trauma, surgical treatment is vital, but sometimes there may be loss of function due to fibrosis. This study aimed to evaluate the effect of autologous omentum flaps on injured renal tissues in a rat model.MethodsA total of 30 Wistar albino rats were included and randomly divided equally into a control group and four intervention groups. Iatrogenic renal injuries were repaired using a surgical technique (primary repair 1 group and primary repair 2 group) or transposition of the autologous omentum (omentum repair 1 group and omentum repair 2 group). Blood samples were taken preoperatively and on the 1st and 7th postoperative days in all groups and on the 18th postoperative day in the control and two intervention groups. All rats were sacrificed on the 7th or 18th day postoperatively, and their right kidneys were taken for histopathological evaluation.ResultsThe mean urea level significantly decreased from day 1 to day 7 and from day 1 to day 18 in the omentum repair 2 group (P = 0.005 and P = 0.004, respectively). There were no other significant changes in urea or creatinine levels within the intervention groups (P > 0.05). There was no significant correlation between the urea and creatinine levels and the histological scores (P > 0.05). The primary repair 1 and 2 groups had significantly higher median granulation and inflammation scores in the kidney specimen than the control and omentum repair groups (P < 0.05). The omentum repair 2 group had significantly lower median granulation and inflammation scores in the surrounding tissues than the primary repair 2 group (P < 0.05). The completion score for the healing process in the kidney specimen was significantly higher in the omentum repair groups than in the primary repair groups (P < 0.05). The omentum repair 2 group had significantly lower median granulation and inflammation scores in the surrounding tissues than the primary repair 2 group (P < 0.05). Granulation degree in the kidney specimen was strongly and positively correlated with the inflammation degree (r = 0.824, P < 0.001) and foreign body reaction in the kidney specimen (r = 0.872, P < 0.001) and a strong and negative correlation with the healing process completion score in the kidney (r = − 0.627, P = 0.001). Inflammation degree in the kidney specimen was strongly and positively correlated with the foreign body reaction in the kidney specimen (r = 0.731, P = 0.001) and strongly and negatively correlated with the healing process completion score in the kidney specimen (r = − 0.608, P = 0.002).ConclusionAutologous omentum tissue for kidney injury repair attenuated inflammation and granulation. Additionally, the use of omental tissue to facilitate healing of kidney injury may theoretically lead to a more effective healing process and reduced fibrosis and tissue and function loss.
Highlights
IntroductionSurgical treatment is vital, but sometimes there may be loss of function due to fibrosis
After renal trauma, surgical treatment is vital, but sometimes there may be loss of function due to fibrosis
This study aimed to evaluate the repair effect of the transposition of the autologous omentum on injured renal tissues in a rat model
Summary
Surgical treatment is vital, but sometimes there may be loss of function due to fibrosis. Hematuria is the Bilgiç et al Military Medical Research (2022) 9:1 main symptom of kidney trauma [1]. The main purpose of treatment is to ensure that the kidney function returns to normal as soon as possible [2]. Renal injuries are classified into 5 grades according to severity. Grade 4–5 injuries in renal tissues are a candidate for surgical treatment. Major kidney injuries caused by blunt trauma are treated with conservative management [2, 3]. The other treatment approaches are open or endoscopic surgical procedures such as laparoscopic/robot-assisted or open partial/total nephrectomy, nephrorraphy, autotransplantation, and embolization
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