The literature increasingly supports expectant (conservative) management of renal trauma - A systematic review

Journal of Trauma - Injury, Infection and Critical Care

Volumn 59, Issue 2, 2005, Pages 493-503

  Santucci, Richard A ^a,b,c   Fisher, Mark B ^b  

^a DETROIT RECEIVING HOSPITAL   (United States)

^b WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c Wayne State University School of Medicine ^*  (United States)

Author keywords

Conservative; Expectant management; Kidney; Nonoperative; Renal trauma

Indexed keywords

ARTIFICIAL EMBOLISM; BLOOD VESSEL INJURY; BLUNT TRAUMA; COLON INJURY; CONSERVATIVE TREATMENT; GUNSHOT INJURY; HEALTH CARE POLICY; HUMAN; INTENSIVE CARE; KIDNEY; KIDNEY ANGIOGRAPHY; KIDNEY BLOOD VESSEL; KIDNEY DISEASE; KIDNEY INJURY; KIDNEY PARENCHYMA; KIDNEY PELVIS; MEDLINE; NEPHRECTOMY; PANCREAS INJURY; PEDIATRICS; PENETRATING TRAUMA; PRIORITY JOURNAL; RENOVASCULAR DISEASE; REVASCULARIZATION; REVIEW; SALVAGE THERAPY; STAB WOUND; SYSTEMATIC REVIEW; URETER INJURY; URINARY DIVERSION; URINE EXTRAVASATION; VASCULAR SURGERY;

HUMANS; KIDNEY; KIDNEY PELVIS; RENAL ARTERY; RENAL VEINS; URINARY DIVERSION; WOUNDS, GUNSHOT; WOUNDS, NONPENETRATING; WOUNDS, PENETRATING; WOUNDS, STAB;

EID: 27844611958     PISSN: 00225282     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.ta.0000179956.55078.c0     Document Type: Review

References (110)

1. Swiersie AK. Experiences and lessons of emergency urological surgery in war. J Urol. 1947;57:938-944.
2. Wessells H, Suh D, Porter JR, et al. Renal injury and operative management in the United States: results of a population-based study. J Trauma. 2003;54:423-430.
3. Sargent JC, Marquartdt CR. Renal injuries. J Urol. 1950;63:1-8.
4. Kristjansson A, Pedersen J. Management of blunt renal trauma. Br J Urol. 1993;72:692-696.
5. Corriere JN, Jr., McAndrew JD, Benson GS. Intraoperative decision-making in renal trauma surgery. J Trauma. 1991;31:1390-1392.
6. Mendez R. Renal trauma. J Urol. 1977;118:698-703.
7. Dobrowolski Z, Kusionowicz J, Drewniak T, et al. Renal and ureteric trauma: diagnosis and management in Poland. BJU Int. 2002;89:748-751.
8. Cass AS, Cass BP. Immediate surgical management of severe renal injuries in multiple- injured patients. Urology. 1983;21:140-145.
9. Cass AS. Immediate radiological evaluation and early surgical management of genitourinary injuries from external trauma. J Urol. 1979;122:772-774.
10. Scott R, Jr., Carlton CE, Jr., Goldman M. Penetrating injuries of the kidney: an analysis of 181 patients. Trans Am Assoc Genitourin Surg. 1968;60:169-174.
11. Rogers CG, Knight V, MacUra KJ et al. High-grade renal injuries in children-is conservative management possible? Urology. 2004; 64:574-579.
12. Hammer CC, Santucci RA. Effect of an institutional policy of nonoperative treatment of grades I to IV renal injuries. J Urol. 2003;169:1751-1753.
13. Danuser H, Wille S, Zoscher G, et al. How to treat blunt kidney ruptures: primary open surgery or conservative treatment with deferred surgery when necessary? Eur Urol 2001;39:9-14.
14. Levy JB, Baskin LS, Ewalt DH, et al. Nonoperative management of blunt pediatric major renal trauma. Urology. 1993;42:418-424.
15. Moudouni SM, Patard JJ, Manunta A, et al. A conservative approach to major blunt renal lacerations with urinary extravasation and devitalized renal segments. BJU Int. 2001;87:290-294.
16. Goff CD, Collin GR. Management of renal trauma at a rural, level I trauma center. Am Surg. 1998;64:226-230.
17. Goffette PP, Laterre PF. Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention). Eur Radiol. 2002;12:994-1021.
18. Herschorn S, Radomski SB, Shoskes DA, et al. Evaluation and treatment of blunt renal trauma. J Urol. 1991;146:274-276; discussion 276-277.
19. Peters PC, Bright TC, 3rd. Blunt renal injuries. Urol Clin North Am. 1977;4:17-28.
20. Thall EH, Stone NN, Cheng DL, et al. Conservative management of penetrating and blunt Type III renal injuries. Br J Urol. 1996; 77:512-517.
21. Heyns CF, Van Vollenhoven P. Selective surgical management of renal stab wounds. Br J Urol. 1992;69:351-357.
22. Bernath AS, Schutte H, Fernandez RR, et al. Stab wounds of the kidney: conservative management in flank penetration. J Urol. 1983;129:468-470.
23. Cheng DL, Lazan D, Stone N. Conservative treatment of type III renal trauma. J Trauma. 1994;36:491-494.
24. Serafetinides E, Mitropoulos D, Constantinedes C, et al. Management of renal gunshot injuries (RGI). J Urol. 2004;171:20.-
25. Sagalowsky AI, McConnell JD, Peters PC. Renal trauma requiring surgery: an analysis of 185 cases. J Trauma. 1983;23:128-131.
26. Velmahos GC, Demetriades D, Cornwell EE, 3rd, et al. Selective management of renal gunshot wounds. Br J Surg. 1998;85:1121-1124.
27. Whitney RF, Peterson NE. Penetrating renal injuries. Urology. 1976;7:7-11.
28. Wessells H, McAninch JW, Meyer A, et al. Criteria for nonoperative treatment of significant penetrating renal lacerations. J Urol. 1997;157:24-27.
29. Schwab CW. Selection of nonoperative management candidates. World J Surg. 2001;25:1389-1392.
30. Knudson MM, Maull KI. Nonoperative management of solid organ injuries. Past, present, and future. Surg Clin North Am. 1999; 79:1357-1371.
31. Santucci RA, Wessells H, Bartsch G, et al. Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee. BJU Int. 2004;93:937-954.
32. Murnaghan ML, Buckley RE. Lost but not forgotten: patients lost to follow-up in a trauma database. Can J Surg. 2002;45:191-195.
33. Wein AJ, Arger PH, Murphy JJ. Controversial aspects of blunt renal trauma. J Trauma. 1977;17:662-666.
34. McAninch JW, Santucci RA. Genitourinary Trauma. In: Walsh, PC, Retik AB, Vaughan, EDJ et al., eds. Campbell's Urology, New York: Saunders, 2002:3707-3744.
35. Santucci RA, McAninch JW. Diagnosis and management of renal trauma: past, present, and future. J Am Coll Surg. 2000;191:443-451.
36. Altman AL, Haas C, Dinchman KH, et al. Selective nonoperative management of blunt grade 5 renal injury. J Urol. 2000;164:27-30; discussion 30-21.
37. Matthews LA, Smith EM, Spirnak JP. Nonoperative treatment of major blunt renal lacerations with urinary extravasation. J Urol. 1997;157:2056-2058.
38. Haller JA, Jr., Papa P, Drugas G, et al. Nonoperative management of solid organ injuries in children. Is it safe? Ann Surg. 1994; 219:625-628; discussion 628-631.
39. Tunberg T, Jona J. Review of multiple traumatic injuries in an urban pediatric population. Pediatr Emerg Care. 1985;1:116-119.
40. Smith EM, Elder JS, Spirnak JP. Major blunt renal trauma in the pediatric population: is a nonoperative approach indicated? J Urol. 1993;149:546-548.
41. Gill B, Palmer LS, Reda E, et al. Optimal renal preservation with timely percutaneous intervention: a changing concept in the management of blunt renal trauma in children in the 1990s. Br J Urol. 1994;74:370-374.
42. Kuzmarov IW, Morehouse DD, Gibson S. Blunt renal trauma in the pediatric population: a retrospective study. J Urol. 1981;126:648-649.
43. Toutouzas KG, Karaiskakis M, Kaminski A, et al. Nonoperative management of blunt renal trauma: a prospective study. Am Surg. 2002;68:1097-1103.
44. Santucci RA, McAninch JW, Safir M, et al. Validation of the American Association for the Surgery of Trauma organ injury severity scale for the kidney. J Trauma. 2001;50:195-200.
45. Moudouni SM, Hadj Slimen M, Manunta A, et al. Management of major blunt renal lacerations: is a nonoperative approach indicated? Eur Urol. 2001;40:409-414.
46. Roberts RA, Belitsky P, Lannon SG, et al. Conservative management of renal lacerations in blunt trauma. Can J Surg. 1987; 30:253-255.
47. Krieger JN, Algood CB, Mason JT, et al. Urological trauma in the Pacific Northwest: etiology, distribution, management and outcome. J Urol. 1984;132:70-73.
48. Gibson S, Kuzmarov IW, McClure DR et al. Blunt renal trauma: the value of a conservative approach to major injuries in clinically stable patients. Can J Surg. 1982;25:25-26.
49. Evins SC, Thomason WB, Rosenblum R. Non-operative management of severe renal lacerations. J Urol. 1980;123:247-249.
50. Thompson IM, Latourette H, Montie JE, et al. Results of nonoperative management of blunt renal trauma. J Urol. 1977; 118:522-524.
51. Perego KL, Little DC, Kirkpatrick AK. Conservative nonoperative management of Grade 5 blunt renal trauma. Journal of Urology. 2001;165:14-15.
52. Husmann DA, Gilling PJ, Perry MO, et al. Major renal lacerations with a devitalized fragment following blunt abdominal trauma: a comparison between nonoperative (expectant) versus surgical management. J Urol. 1993;150:1774-1777.
53. Wilson RF, Ziegler DW. Diagnostic and treatment problems in renal injuries. Am Surg. 1987;53:399-402.
54. Velmahos GC, Demetriades D, Toutouzas KG, et al. Selective nonoperative management in 1,856 patients with abdominal gunshot wounds: should routine laparotomy still be the standard of care? Ann Surg. 2001;234:395-402; discussion 402-393.
55. Peterson NE. Complications of renal trauma. Urol Clin North Am. 1989;16:221-236.
56. Heyns CF, De Klerk DP, De Kock ML. Nonoperative management of renal stab wounds. J Urol. 1985;134:239-242.
57. Armenakas NA, Duckett CP, McAninch JW. Indications for nonoperative management of renal stab wounds. J Urol. 1999; 161:768-771.
58. Wessells H, Deirmenjian J, McAninch JW. Preservation of renal function after reconstruction for trauma: quantitative assessment with radionuclide scintigraphy. J Urol. 1997;157:1583-1586.
59. Eastham JA, Wilson TG, Ahlering TE. Urological evaluation and management of renal-proximity stab wounds. J Urol. 1993; 150:1771-1773.
60. Sutherland JPS. Rebleeding after majour blunt renal trauma: Is surgical exploration mandatory? J Urol. 2001;165:15.-
61. Chmielewski GW, Nicholas JM, Dulchavsky SA, et al. Nonoperative management of gunshot wounds of the abdomen. Am Surg. 1995;61:665-668.
62. Demetriades D, Charalambides D, Lakhoo M, et al. Gunshot wound of the abdomen: role of selective conservative management. Br J Surg. 1991;78:220-222.
63. Ersay A, Akgun Y. Experience with renal gunshot injuries in a rural setting. Urology. 1999;54:972-975.
64. Santucci RA, Chang YJ. Ballistics for physicians: myths about wound ballistics and gunshot injuries. J Urol. 2004;171:1408-1414.
65. Feliciano DV. Management of traumatic retroperitoneal hematoma. Ann Surg. 1990;211:109-123.
66. McAninch JW, Carroll PR, Armenakas NA, et al. Renal gunshot wounds: methods of salvage and reconstruction. J Trauma. 1993; 35:279-283; discussion 283-274.
67. McGonigal MD, Lucas CE, Ledgerwood AM. The effects of treatment of renal trauma on renal function. J Trauma. 1987; 27:471-476.
68. Narrod JA, Moore EE, Posner M, et al. Nephrectomy following trauma-impact on patient outcome. J Trauma. 1985;25:842-844.
69. Robert M, Drianno N, Muir G, et al. Management of major blunt renal lacerations: surgical or nonoperative approach? Eur Urol. 1996;30:335-339.
70. Santucci RA, Broghammer J, Langenberg S, et al. Conservative management of pediatric renal trauma. BJU Int. 2004;94:39.-
71. Knudson MM, Harrison PB, Hoyt DB, et al. Outcome after major renovascular injuries: a Western trauma association multicenter report. J Trauma. 2000;49:1116-1122.
72. Turner WW, Jr., Snyder WH, 3rd, Fry WJ. Mortality and renal salvage after renovascular trauma. A review of 94 patients treated in a 20 year period. Am J Surg. 1983;146:848-851.
73. Haas CA, Dinchman KH, Nasrallah PF, et al. Traumatic renal artery occlusion: a 15-year review. J Trauma. 1998;45:557-561.
74. Ivatury RR, Zubowski R, Stahl WM. Penetrating renovascular trauma. J Trauma. 1989;29:1620-1623.
75. Carroll PR. Renovascular trauma: Evaluation and management. Prob Urol. 1994;8:191.-
76. Cass AS, Bubrick M, Luxenberg M, et al. Renal pedicle injury in patients with multiple injuries. J Trauma. 1985;25:892-896.
77. Brown MF, Graham JM, Mattox KL, et al. Renovascular trauma. Am J Surg. 1980;140:802-805.
78. Clark DE, Georgitis JW, Ray FS. Renal arterial injuries caused by blunt trauma. Surgery. 1981;90:87-96.
79. Stables DP, Fouche RF, de Villiers van Niekerk JP, et al. Traumatic renal artery occlusion: 21 cases. J Urol. 1976;115:229-233.
80. Barlow B, Gandhi R. Renal artery thrombosis following blunt trauma. J Trauma. 1980;20:614-617.
81. Elliott SP, Alsikafi N, Minor T, et al. Renal vein injuries from external trauma. BJU Int. 2004;94:38-
82. Bertini JE, Jr., Flechner SM, Miller P, et al. The natural history of traumatic branch renal artery injury. J Urol. 1986;135:228-230.
83. Bruce LM, Croce MA, Santaniello JM, et al. Blunt renal artery injury: incidence, diagnosis, and management. Am Surg. 2001; 67:550-554; discussion 555-556.
84. Mansi MK, Alkhudair WK. Conservative management with percutaneous intervention of major blunt renal injuries. Am J Emerg Med. 1997;15:633-637.
85. Nance ML, Lutz N, Carr MC, et al. Blunt renal injuries in children can be managed nonoperatively: outcome in a consecutive series of patients. J Trauma. 2004;57:474-478; discussion 478.
86. Wilkinson AG, Haddock G, Carachi R. Separation of renal fragments by a urinoma after renal trauma: percutaneous drainage accelerates healing. Pediatr Radiol. 1999;29:503-505.
87. Uflacker R, Paolini RM, Lima S. Management of traumatic hematuria by selective renal artery embolization. J Urol. 1984; 132:662-667.
88. De Bock L, Verhagen PF. Selective embolization in the treatment of severe blunt renal injury. Neth J Surg. 1989;41:31-34.
89. Reilly KJ, Shapiro MB, Haskal ZJ. Angiographic embolization of a penetrating traumatic renal arteriovenous fistula. J Trauma. 1996; 41:763-765.
90. Tucci P, Doctor D, Diagonale A. Embolization of post-traumatic renal arteriovenous fistula. Urology. 1979;13:192-194.
91. Khan AB, Reid AW. Management of renal stab wounds by arteriographic embolisation. Scand J Urol Nephrol. 1994;28:109-110.
92. Santucci RA, Langenburg SE, Zachareas MJ. Traumatic hematuria in children can be evaluated as in adults. J Urol. 2004;171:822-825.
93. Russell RS, Gomelsky A, McMahon DR et al. Management of grade IV renal injury in children. J Urol. 2001;166:1049-1050.
94. Husmann DA, Morris JS. Attempted nonoperative management of blunt renal lacerations extending through the corticomedullary junction: the short-term and long-term sequelae. J Urol. 1990; 143:682-684.
95. Rosen MA, McAninch JW. Management of combined renal and pancreatic trauma. J Urol. 1994;152:22-25.
96. McAninch JW, Carroll PR, Klosterman PW, et al. Renal reconstruction after injury. J Urol. 1991;145:932-937.
97. Presti JC, Jr., Carroll PR, McAninch JW. Ureteral and renal pelvic injuries from external trauma: diagnosis and management. J Trauma. 1989;29:370-374.
98. Liroff SA, Pontes JE, Pierce JM, Jr. Gunshot wounds of the ureter: 5 years of experience. J Urol. 1977;118:551-553.
99. Mulligan JM, Cagiannos I, Collins JP, et al. Ureteropelvic junction disruption secondary to blunt trauma: excretory phase imaging (delayed films) should help prevent a missed diagnosis. J Urol. 1998;159:67-70.
100. Kenney PJ, Panicek DM, Witanowski LS. Computed tomography of ureteral disruption. J Comput Assist Tomogr. 1987;11:480-484.
101. Esho JO, Ireland GW, Cass AS. Renal trauma and preexisting lesions of kidney. Urology. 1973;1:134-135.
102. Hicks CC, Lewis EL. Traumatic rupture of horseshoe kidney. J Trauma. 1977;17:158-160.
103. Schmidlin FR, Iselin CE, Naimi A, et al. The higher injury risk of abnormal kidneys in blunt renal trauma. Scand J Urol Nephrol. 1998;32:388-392.
104. Brower P, Paul J, Brosman SA. Urinary tract abnormalities presenting as a result of blunt abdominal trauma. J Trauma. 1978; 18:719-722.
105. Rhyner P, Federle MP, Jeffrey RB. CT of trauma to the abnormal kidney. AJR Am J Roentgenol. 1984;142:747-750.
106. Nation EF, Massey BD. Renal trauma: Experience with 258 cases. J Urol. 1963;89:775-778.
107. Morey AF, Bruce JE, McAninch JW. Efficacy of radiographic imaging in pediatric blunt renal trauma. J Urol. 1996;156:2014-2018.
108. Schmidlin FR, Schmid P, Kurtyka T, et al. Force transmission and stress distribution in a computer-simulated model of the kidney: an analysis of the injury mechanisms in renal trauma. J Trauma. 1996; 40:791-796.
109. Sebastia MC, Rodriguez-Dobao M, Quiroga S, et al. Renal trauma in occult ureteropelvic junction obstruction: CT findings. Eur Radiol. 1999;9:611-615.
110. Lazar L, Buchumensky V, Erez I, et al. Conservative treatment of an injured hydronephrotic kidney: the role of percutaneous nephrostomy. J Trauma. 1996;40:304-305.