Preliminary vascular control for renal trauma

A. Atala, F. B. Miller, J. D. Richardson, B. Bauer, J. Harty, M. Amin

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Preliminary control of the renal vascular pedicle prior to opening Gerota's fascia is advocated as the standard approach for decreasing the rate of nephrectomy from trauma. This method, however, has not been studied widely. Previous reports failed to grade the severity of the renal injury and involved small patient series and historic control for comparison of nephrectomy rates. We studied 297 patients with renal trauma during a ten year period. Sixty-three of 75 patients with penetrating injuries and 12 of 222 patients with blunt injuries underwent renal exploration. We obtained vascular control prior to opening Gerota's fascia in 32 patients; it was obtained in 43 patients after opening Gerota's fascia. The nephrectomy rate depended on the degree of injury rather than on the type of renal vascular control obtained. Obtaining vascular control after opening Gerota's fascia did not increase the nephrectomy rate and shortened operative time by an average of 58 minutes. We recommend vascular control after opening Gerota's fascia when there is a large hematoma crossing the midline, a rapidly expanding renal hematoma, if the patient is unstable, or if Gerota's fascia has already been opened by the injury.

Original languageEnglish (US)
Pages (from-to)386-390
Number of pages5
JournalSurgery Gynecology and Obstetrics
Issue number5
StatePublished - Jan 1 1991

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology


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