Role of Repeat Imaging in Renal Trauma Management: Results of a French Multicentric Study (TRAUMAFUF)

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) II1 Apr 2017PD63-04 ROLE OF REPEAT IMAGING IN RENAL TRAUMA MANAGEMENT : RESULTS OF A FRENCH MULTICENTRIC STUDY (TRAUMAFUF) Reem BETARI, Gaelle FIARD, Marine RUGGIERO, Ines DOMINIQUE, Lucas FRETON, Jonathan OLIVIER, Quentin LANGOUET, Clémentine MILLET, Sébastien BERGERAT, Paul PANAYATOPOULOS, Xavier MATILLON, Ala CHEBBI, Thomas CAES, Pierre-Marie PATARD, Nicolas SZABLA, Nicolas BRICHART, Laura SABOURIN, Kerem GULERYUZ, Charles DARIANE, Cédric LEBACLE, Jérôme RIZK, François-Xavier MADEC, François-Xavier NOUHAUD, Benjamin PRADERE, Xavier ROD, Marine HUTIN, and Benoit PEYRONNET Reem BETARIReem BETARI More articles by this author , Gaelle FIARDGaelle FIARD More articles by this author , Marine RUGGIEROMarine RUGGIERO More articles by this author , Ines DOMINIQUEInes DOMINIQUE More articles by this author , Lucas FRETONLucas FRETON More articles by this author , Jonathan OLIVIERJonathan OLIVIER More articles by this author , Quentin LANGOUETQuentin LANGOUET More articles by this author , Clémentine MILLETClémentine MILLET More articles by this author , Sébastien BERGERATSébastien BERGERAT More articles by this author , Paul PANAYATOPOULOSPaul PANAYATOPOULOS More articles by this author , Xavier MATILLONXavier MATILLON More articles by this author , Ala CHEBBIAla CHEBBI More articles by this author , Thomas CAESThomas CAES More articles by this author , Pierre-Marie PATARDPierre-Marie PATARD More articles by this author , Nicolas SZABLANicolas SZABLA More articles by this author , Nicolas BRICHARTNicolas BRICHART More articles by this author , Laura SABOURINLaura SABOURIN More articles by this author , Kerem GULERYUZKerem GULERYUZ More articles by this author , Charles DARIANECharles DARIANE More articles by this author , Cédric LEBACLECédric LEBACLE More articles by this author , Jérôme RIZKJérôme RIZK More articles by this author , François-Xavier MADECFrançois-Xavier MADEC More articles by this author , François-Xavier NOUHAUDFrançois-Xavier NOUHAUD More articles by this author , Benjamin PRADEREBenjamin PRADERE More articles by this author , Xavier RODXavier ROD More articles by this author , Marine HUTINMarine HUTIN More articles by this author , and Benoit PEYRONNETBenoit PEYRONNET More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2928AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal trauma is the most common type of genitourinary injury. In the management of renal trauma, a repeat imaging is recommended two to seven days after the initial trauma to seek for missed complications. However, the data on which this recommendation is based are scarce and controversial. The aim of this study was to evaluate the impact of the routine use of repeat imaging after renal trauma. METHODS A nationwide multicentric retrospective study including all patients referred for renal trauma has been conducted in fifteen trauma centers between 2005 and 2015. Patients were divided into three groups : no routine repeat Imaging (NRIM), repeat imaging in asymptomatic patient (SYSTIM), repeat imaging in symptomatic patient (SYMPTIM). The three groups were compared, and multivariate analysis were performed to seek for predictive factors of secondary surgery/interventional radiology, change in patient management and readmission. RESULTS Out of 927 patients who were treated fo renal trauma, 758 had repeat imaging (81.8 %) : 583 (76.9 %) had routine repeat imaging while asymptomatic (SYSTIM), 175 (23,1 %) had repeat imaging due to symptoms (SYMPTIM). The median interval between trauma and repeat imaging was five days if there were no symptoms, and seven days if patients had symptoms. A relevant finding was made more frequently in the SYMPTIM group than in the SYSTIM group (57.1 % vs. 24.1 %, p<0.0001). In thirty patients who had routine repeat imaging (5.1 %), secondary surgery/interventional radiology was needed based on imaging findings, : 19 ureteral stent, 4 percutaneous drainage, 6 embolization and a diaphragmatic tear repair. Initial management was modified in 64 (38.2 %) patients from the SYMPTIM group. There was no significative difference in terms of readmission in the NRIM group vs. the SYSTIM group (2.9 % vs. 3.6 %, p = 0.81). CONCLUSIONS In our study, repeat imaging within 10 days following renal trauma was performed in 81.8% of patients but did change the management in only 5.1% of asymptomatic patients. Repeat imaging after renal trauma could be proposed only to symptomatic patients, with active bleeding or urinary extravasation on the initial CT and patients at risk of renal pseudo-aneurysm. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1255-e1256 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Reem BETARI More articles by this author Gaelle FIARD More articles by this author Marine RUGGIERO More articles by this author Ines DOMINIQUE More articles by this author Lucas FRETON More articles by this author Jonathan OLIVIER More articles by this author Quentin LANGOUET More articles by this author Clémentine MILLET More articles by this author Sébastien BERGERAT More articles by this author Paul PANAYATOPOULOS More articles by this author Xavier MATILLON More articles by this author Ala CHEBBI More articles by this author Thomas CAES More articles by this author Pierre-Marie PATARD More articles by this author Nicolas SZABLA More articles by this author Nicolas BRICHART More articles by this author Laura SABOURIN More articles by this author Kerem GULERYUZ More articles by this author Charles DARIANE More articles by this author Cédric LEBACLE More articles by this author Jérôme RIZK More articles by this author François-Xavier MADEC More articles by this author François-Xavier NOUHAUD More articles by this author Benjamin PRADERE More articles by this author Xavier ROD More articles by this author Marine HUTIN More articles by this author Benoit PEYRONNET More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...