2015 William Hunter Harridge lecture: how did we go from operating on nearly all injured kidneys to operating on almost none of them?

American Journal of Surgery
Richard A Santucci

Abstract

The 2015 William H. Harridge lecture of the 2015 Midwest Surgical Association concentrated on the evolution and performance characteristics of nonoperative management of even severe renal injury. One of the first mentions of nonoperative renal trauma occurs after World War II. Since that time through the early 2000s, only 1 or fewer papers per year appeared in the literature. The mid-2000s had an explosion of interest and publications on the subject, resulting in our modern understanding of the principles. The principles of nonoperative management are as follows: (1) operate immediately if the patient is bleeding to death; (2) observe initially, but step in with metered responses as necessary; (3) use ureteral stents for symptomatic or growing urinoma; (4) use angioembolization for nonemergent bleeding or for urgent bleeding if your center can manage this; and (5) do open surgery when needed (not "never").

References

Apr 1, 1992·British Journal of Urology·C F Heyns, P Van Vollenhoven
Aug 26, 1998·The British Journal of Surgery·G C VelmahosT V Berne
Mar 14, 2003·The Journal of Trauma·Hunter WessellsAvery B Nathens
Apr 11, 2003·The Journal of Urology·Clarisa C Hammer, Richard A Santucci
May 27, 2014·The Journal of Urology·Allen F MoreyHunter Wessells

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Citations

Jan 4, 2018·The Journal of Trauma and Acute Care Surgery·Sorena KeihaniUNKNOWN Genito-Urinary Trauma Study Group
Dec 13, 2019·World Journal of Emergency Surgery : WJES·Federico CoccoliniUNKNOWN WSES-AAST Expert Panel
Jan 3, 2018·World Journal of Urology·Elias J PretoriusRichard D Pitcher
Nov 25, 2018·Nature Reviews. Urology·Sorena KeihaniJeremy B Myers
Oct 20, 2020·The Journal of Trauma and Acute Care Surgery·Sorena KeihaniUNKNOWN in conjunction with the Trauma and Urologic Reconstruction Network of Surgeons

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