Academic Journal
Management of adult renal trauma: a practice management guideline from the eastern association for the surgery of trauma
| العنوان: | Management of adult renal trauma: a practice management guideline from the eastern association for the surgery of trauma |
|---|---|
| المؤلفون: | Aziz H. A., Bugaev N., Baltazar G., Brown Z., Haines K., Gupta S., Yeung L., Posluszny J., Como J., Freeman J., Kasotakis G. |
| المصدر: | BMC Surgery |
| بيانات النشر: | BioMed Central Ltd |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Blunt, Embolization, Genitourinary tract, Injury, Kidney, Kidney preservation, Nephrectomy, Penetrating, Renal laceration, Trauma, Wounds |
| الوصف: | Background: The kidney is the most frequently injured component of the genitourinary system, accounting for 5% of all trauma cases. Several guidelines by different societies address the management of urological trauma. However, unanswered questions remain regarding optimal use of angioembolization in hemodynamically stable patients, indications for operative exploration of stable retroperitoneal hematomas and renal salvage techniques in the setting of hemodynamic instability, and imaging practices for patients undergoing non-operative management. We performed a systematic review, meta-analysis, and developed evidence-based recommendations to answer these questions in both blunt and penetrating renal trauma. Methods: The working group formulated four population, intervention, comparator, outcome (PICO) questions regarding the following topics: (1) angioembolization (AE) usage in hemodynamically stable patients with evidence of ongoing bleeding; (2) surgical approach to stable zone II hematomas (exploration vs. no exploration) in hemodynamically unstable patients and (3) surgical technique (nephrectomy vs. kidney preservation) for expanding zone II hematomas in hemodynamically unstable patients; (4) frequency of repeat imaging (routine or symptom based) in high-grade traumatic renal injuries. A systematic review and meta-analysis of currently available evidence was performed. RevMan 5 (Cochran Collaboration) and GRADEpro (Grade Working Group) software were used. Recommendations were voted on by working group members and concurrence was obtained for each final recommendation. Results: A total of 20 articles were identified and analyzed. Two prospective studies were encountered; the majority were retrospective, single-institution studies. Not all outcomes projected by PICO questions were reported in all studies. Meta-analysis was performed for all PICO questions except PICO 3 secondary to the discrepant patient populations included in those studies. PICO 1 had the greatest number of articles included in the ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | https://doi.org/10.1186/s12893-023-01914-x; https://repository.tcu.edu/handle/116099117/61130 |
| DOI: | 10.1186/s12893-023-01914-x |
| الاتاحة: | https://repository.tcu.edu/handle/116099117/61130 https://doi.org/10.1186/s12893-023-01914-x |
| Rights: | CC BY 4.0 |
| رقم الانضمام: | edsbas.B1F93844 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s12893-023-01914-x |
|---|