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Revista Colombiana de Cirugía

Print version ISSN 2011-7582On-line version ISSN 2619-6107

Abstract

DELGADO-LOPEZ, Carlos Andrés et al. Outcomes in the management of patients with renal trauma admitted to a level 1 Trauma Center. rev. colomb. cir. [online]. 2021, vol.36, n.4, pp.666-676.  Epub Feb 16, 2022. ISSN 2011-7582.  https://doi.org/10.30944/20117582.846.

Introduction.

The debate about the management of patients with renal trauma continues, but the conservative strategy is increasingly supported. In this study, the results of non-operative management in renal trauma are presented, evaluating the variables that determined treatment failures and their subsequent management.

Methods.

Retrospective observational study. Patients older than 15 years with renal trauma confirmed by CT were included. Patients operated on in the first four hours, kidney transplants, and previous nephrectomy were excluded. Demographic variables, vital signs, injury characteristics, management and outcomes were recorded.

Results.

Ninety-seven patients were included, of which 82.5% (n=80) had conservative management. Blunt trauma occurred in 56.7% (n=55) and the high-grade injuries corresponded to 67% (n=65). The main findings were abdominal pain, gross hematuria, and wounds in the lumbar tract. The 73.2% (n=71) had associated injuries and 31.9% (n=31) required transfusion. The patients with failure in the conservative management were older, had a lower score on the Glasgow Coma Scale, and associated trauma. The efficacy of non-operative management was 83% (n=67). The six-day hospital stay and the mortality of 9.3% (n=9), was not exclusively related to kidney trauma but to the severity of the trauma.

Discussion.

Kidney trauma is not uncommon and is generally associated with other injuries. Conservative management has shown a reduction in unnecessary interventions, associated complications, and nephrectomies.

Keywords : trauma; renal; treatment; surgery, observation, mortality.

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