In a study of 535 patients with renal trauma admitted to the Medical College of Virginia Hospitals from 1962 to 1988, the authors found indications of a decrease in the rate of total nephrectomy in patients with blunt trauma, due in part to advances in diagnostic technology. In the cases of gunshot wounds, however, a persistently high rate of nephrectomy prevailed, reflecting, the authors believe, the proliferation of increasingly lethal weaponry.
In summary, we have found this technique to be useful in patients in whom coagulation therapy is not possible or effective. It must still be considered a technique which is undergoing evaluation. Prospective randomized trials comparing this therapy with other currently available therapies such a electrocoagulation, laser and conservative management must be completed to firmly define its place in treatment strategy for acute upper GI bleeding.
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