Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis
Background: Irrespective of the high incidence of grade IV renal trauma, there is still an ongoing debate regarding the use of conservative and surgical approaches for its treatment. This study aimed to conduct pooled analyses of published studies that concluded evidences regarding the management of...
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| Format: | Article |
| Language: | English |
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Universitas Indonesia
2019-08-01
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| Series: | Makara Journal of Health Research |
| Subjects: | |
| Online Access: | https://scholarhub.ui.ac.id/mjhr/vol23/iss2/2/ |
| _version_ | 1797893861471682560 |
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| author | Ikhlas A. Bramono Gampo A. Irdam Arry Rodjani Irfan Wahyudi |
| author_facet | Ikhlas A. Bramono Gampo A. Irdam Arry Rodjani Irfan Wahyudi |
| author_sort | Ikhlas A. Bramono |
| collection | DOAJ |
| description | Background: Irrespective of the high incidence of grade IV renal trauma, there is still an ongoing debate regarding the use of conservative and surgical approaches for its treatment. This study aimed to conduct pooled analyses of published studies that concluded evidences regarding the management of grade IV renal trauma. Methods: Published studies between 1995 and 2015 from Cochrane Library, EBSCO, Embase, ProQuest, PubMed, and Scopus were reviewed and pooled analysis of eligible studies was conducted using random effects model. Heterogeneity was presented with I2 and p value. Results: Eleven studies reporting on 703 adults were included in the analysis. Conservative approach was used in 611 patients (conservative group) and surgical approach in 92 patients (surgical group); success rate and morbidity were comparable between the groups (risk ratio (RR): 1.15, 95% confidence interval (CI): 0.72–1.83; RR: 0.77, 95% CI: 0.27–2.21, respectively). The trend of mortality was higher in the surgical group than the conservative group. Conclusions: A comparable success rate was observed between the groups. Mortality was higher in the surgical group than the conservative group. As advocated by many guidelines, conservative management may decrease unnecessary exploration, which can ultimately reduce reconstruction and/or nephrectomy rate without causing morbidity or mortality. |
| first_indexed | 2024-04-10T06:59:41Z |
| format | Article |
| id | doaj.art-9e8895ff8b37447da9316df2d68ef2d5 |
| institution | Directory Open Access Journal |
| issn | 2356-3664 2356-3656 |
| language | English |
| last_indexed | 2024-04-10T06:59:41Z |
| publishDate | 2019-08-01 |
| publisher | Universitas Indonesia |
| record_format | Article |
| series | Makara Journal of Health Research |
| spelling | doaj.art-9e8895ff8b37447da9316df2d68ef2d52023-02-28T02:55:47ZengUniversitas IndonesiaMakara Journal of Health Research2356-36642356-36562019-08-01232727710.7454/msk.v23i2.10379Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysisIkhlas A. Bramono0Gampo A. Irdam1Arry Rodjani2Irfan Wahyudi3Department of Urology, RSUPN Dr. Cipto Mangunkusumo, Faculty of Medicine, Universitas Indonesia, IndonesiaDepartment of Urology, RSUPN Dr. Cipto Mangunkusumo, Faculty of Medicine, Universitas Indonesia, IndonesiaDepartment of Urology, RSUPN Dr. Cipto Mangunkusumo, Faculty of Medicine, Universitas Indonesia, IndonesiaDepartment of Urology, RSUPN Dr. Cipto Mangunkusumo, Faculty of Medicine, Universitas Indonesia, IndonesiaBackground: Irrespective of the high incidence of grade IV renal trauma, there is still an ongoing debate regarding the use of conservative and surgical approaches for its treatment. This study aimed to conduct pooled analyses of published studies that concluded evidences regarding the management of grade IV renal trauma. Methods: Published studies between 1995 and 2015 from Cochrane Library, EBSCO, Embase, ProQuest, PubMed, and Scopus were reviewed and pooled analysis of eligible studies was conducted using random effects model. Heterogeneity was presented with I2 and p value. Results: Eleven studies reporting on 703 adults were included in the analysis. Conservative approach was used in 611 patients (conservative group) and surgical approach in 92 patients (surgical group); success rate and morbidity were comparable between the groups (risk ratio (RR): 1.15, 95% confidence interval (CI): 0.72–1.83; RR: 0.77, 95% CI: 0.27–2.21, respectively). The trend of mortality was higher in the surgical group than the conservative group. Conclusions: A comparable success rate was observed between the groups. Mortality was higher in the surgical group than the conservative group. As advocated by many guidelines, conservative management may decrease unnecessary exploration, which can ultimately reduce reconstruction and/or nephrectomy rate without causing morbidity or mortality.https://scholarhub.ui.ac.id/mjhr/vol23/iss2/2/conservative treatmentkidneynonpenetrating woundssurgical treatment |
| spellingShingle | Ikhlas A. Bramono Gampo A. Irdam Arry Rodjani Irfan Wahyudi Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis Makara Journal of Health Research conservative treatment kidney nonpenetrating wounds surgical treatment |
| title | Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis |
| title_full | Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis |
| title_fullStr | Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis |
| title_full_unstemmed | Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis |
| title_short | Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis |
| title_sort | management of grade iv blunt renal trauma in adults systematic review and meta analysis |
| topic | conservative treatment kidney nonpenetrating wounds surgical treatment |
| url | https://scholarhub.ui.ac.id/mjhr/vol23/iss2/2/ |
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