2012
DOI: 10.1111/j.1464-410x.2012.11578.x
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High‐grade renal injury: non‐operative management of urinary extravasation and prediction of long‐term outcomes

Abstract: E 2 4 9What ' s known on the subject? and What does the study add? High-grade renal trauma seems to be eligible for conservative management. Ureteric stent placement raises issues about its usefulness and its timing. Predictive factors of post-trauma function and surgery need to be known.Urinary extravasation is not associated with poor functional outcome. Ureteric stenting is needed only in case of sepsis and ureteric clot retention. The only independent predictor of long-term renal function is the importance… Show more

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Cited by 49 publications
(43 citation statements)
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“…Long et al [29] have attempted to predict non-operative approach outcomes of urinary extravasation following grade IV blunt renal trauma. Among patients with a urinary leak, endoscopic, ureteral stent placement and open surgery were required in 37.5 and 15.2 %, respectively.…”
Section: Resultsmentioning
confidence: 99%
“…Long et al [29] have attempted to predict non-operative approach outcomes of urinary extravasation following grade IV blunt renal trauma. Among patients with a urinary leak, endoscopic, ureteral stent placement and open surgery were required in 37.5 and 15.2 %, respectively.…”
Section: Resultsmentioning
confidence: 99%
“…The benefit of non-operative management in major renal injuries is now well recognized among specialists [1][2][3][4]8,9 and should be initiated in all hemodynamically stable patients according to European and American guidelines 10,11 . However, the challenge remains to carefully identify patients for whom this non-invasive approach will not be profitable to prevent potentially harmful unnecessary delays.…”
Section: Discussionmentioning
confidence: 99%
“…In one study, even when grade IV injuries were initially managed non-operatively 11% of patients ultimately required renal exploration, 27% required ureteric stenting, and 25% required embolization. [13] Given the high rate of renal loss and the improved results with expectant treatment, the decision to perform immediate surgery must be weighed carefully. In decision making process, accurate assessment of the extent of injury is invaluable.…”
Section: Gradementioning
confidence: 99%