Mp79-01 Nephrectomy After High-Grade Renal Trauma: Results From the American Association for the Surgery of Trauma (Aast) Genitourinary Trauma Study

Keihani, Sorena; Xu, Yizhe; Presson, Angela P.; Smith, Brian P.; Reilly, Patrick; Luo-Owen, Xian; Mukherjee, Kaushik; Morris, Bradley J.; Majercik, Sarah; Thomsen, Peter; Erickson, Bradley; Breyer, Benjamin N.; Murphy, G.P.; Shaffer, Barbara; Carrick, Matthew M.; Miller, Brandi; Santucci, Richard A.; Hewitt, Timothy; Burks, Frank; DeSoucy, Erik S.; Zakaluzny, Scott; Allen, LaDonna; Kocik, Jurek; Nirula, Raminder; Myers, Jeremy B.

doi:10.1016/j.juro.2017.02.2485

Cited by 13 publications

(28 citation statements)

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“…14 However, the analyses from these two studies were not conducted specifically for grade IV renal trauma, which may affect the results, particularly with the inclusion of grade III renal trauma in the analysis of Mingoli et al 13,14 A general consensus regarding the conservative management of renal parenchymal injury has been established, indicating that patients with renal parenchymal injury will require surgery if the hemodynamic condition is unstable. 30 Renal hila hematoma and renal vein thrombosis in grade IV renal trauma should be managed with strict monitoring. 30 Nephrectomy may be necessary when renovascular hypertension or bleeding eventually occurs.…”

Section: Discussionmentioning

confidence: 99%

“…30 Renal hila hematoma and renal vein thrombosis in grade IV renal trauma should be managed with strict monitoring. 30 Nephrectomy may be necessary when renovascular hypertension or bleeding eventually occurs. 30 Meanwhile, in renal artery thrombosis, nephrectomy is advised.…”

Section: Discussionmentioning

confidence: 99%

“…30 Nephrectomy may be necessary when renovascular hypertension or bleeding eventually occurs. 30 Meanwhile, in renal artery thrombosis, nephrectomy is advised. 30 Interventions for renal injuries can be conducted in patients with hemodynamic instability caused by renal bleeding, uncorrected renal injury classification, ureter injury, renal pelvis injury, and renovascular injury.…”

Section: Discussionmentioning

confidence: 99%

“…30 Meanwhile, in renal artery thrombosis, nephrectomy is advised. 30 Interventions for renal injuries can be conducted in patients with hemodynamic instability caused by renal bleeding, uncorrected renal injury classification, ureter injury, renal pelvis injury, and renovascular injury. Conservative management is based on the findings of computed tomography in patients with hemodynamic stability and results of the intraoperative assessment during laparotomy using one-shot intravenous urography in patients with hemodynamic instability.…”

Section: Discussionmentioning

confidence: 99%

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Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis

Bramono¹,

Irdam²,

Rodjani³

et al. 2019

msk

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Background: Irrespective of the high incidence of grade IV renal trauma, there is still an ongoing debate regarding the use of conservative and surgical approaches for its treatment. This study aimed to conduct pooled analyses of published studies that concluded evidences regarding the management of grade IV renal trauma. Methods: Published studies between 1995 and 2015 from Cochrane Library, EBSCO, Embase, ProQuest, PubMed, and Scopus were reviewed and pooled analysis of eligible studies was conducted using random effects model. Heterogeneity was presented with I 2 and p value. Results: Eleven studies reporting on 703 adults were included in the analysis. Conservative approach was used in 611 patients (conservative group) and surgical approach in 92 patients (surgical group); success rate and morbidity were comparable between the groups (risk ratio (RR): 1.15, 95% confidence interval (CI): 0.72-1.83; RR: 0.77, 95% CI: 0.27-2.21, respectively). The trend of mortality was higher in the surgical group than the conservative group. Conclusions: A comparable success rate was observed between the groups. Mortality was higher in the surgical group than the conservative group. As advocated by many guidelines, conservative management may decrease unnecessary exploration, which can ultimately reduce reconstruction and/or nephrectomy rate without causing morbidity or mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis

Bramono¹,

Irdam²,

Rodjani³

et al. 2019

msk

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“…For severe pelvic, junctional, or proximal lower extremity hemorrhage, the balloon catheter can be inflated at the distal abdominal aorta grade of injury and more on the patient's hemodynamic status and responsiveness to resuscitation. 95 Minimally invasive techniques such as angioembolization and endourologic interventions are also being used as adjuncts to nonoperative management. In a study of 206 patients with grade 4 or 5 renal injuries, 74.8% were managed nonoperatively.…”

Section: Renal Injuriesmentioning

confidence: 99%

Minimally Invasive Management of Abdominal Trauma

2018

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Management of traumatic abdominal injuries has traditionally relied upon a combination of systematic physical examination, image-guided evaluation, clinical judgment, and, when necessary, maximally invasive surgical intervention. Advances in the fields of interventional radiology, endoscopy, and laparoscopy have altered these traditional treatment algorithms. As growth of these techniques continues, an increasing number of minimally invasive strategies are available to clinicians for the management of abdominal trauma. Here reviewed is a brief overview of minimally invasive strategies for the management of non–solid organ abdominal trauma with a focus on new, minimally invasive diagnostic and treatment tools.

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Facteurs prédictifs d’échec du traitement conservateur du traumatisme rénal grade III–V

Latabi¹,

Aitzirri²,

Moudouni³

et al. 2019

Progrès en Urologie

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Mp79-01 Nephrectomy After High-Grade Renal Trauma: Results From the American Association for the Surgery of Trauma (Aast) Genitourinary Trauma Study

Cited by 13 publications

References 0 publications

Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis

Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis

Minimally Invasive Management of Abdominal Trauma

Facteurs prédictifs d’échec du traitement conservateur du traumatisme rénal grade III–V

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