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Urologic trauma is frequently reported in patients with penetrating trauma. Currently, the computerized tomography and vascular approach through angiography/embolization are the standard approaches for renal trauma. However, the management of renal or urinary tract trauma in a patient with hemodynamic instability and criteria for emergency laparotomy, is a topic of discussion. This article presents the consensus of the Trauma and Emergency Surgery Group (CTE) from Cali, for the management of penetrating renal and urinary tract trauma through damage control surgery. Intrasurgical perirenal hematoma characteristics, such as if it is expanding or actively bleeding, can be a reference for deciding whether a conservative approach with subsequent radiological studies is possible. However, if there is evidence of severe kidney trauma, surgical exploration is mandatory and entails a high probability of requiring a nephrectomy. Urinary tract damage control should be conservative and deferred because this type of trauma does not represent a risk in acute trauma management.

Alexander Salcedo, Universidad Icesi, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Fundación Valle del Lili. Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Hospital Universitario del Valle, Cali, Colombia.

orcid_id14.png https://orcid.org/0000-0001-8187-0638

Carlos Alberto Ordoñez, • Division of Trauma and Acute Care Surgery, Department of Surgery. Fundación Valle del Lili. Cali, Colombia. • Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. • Universidad Icesi, Cali, Colombia.

orcid_id14.png https://orcid.org/0000-0003-4495-7405

Michael W Parra, Department of Trauma Critical Care, Broward General Level I Trauma Center, Fort Lauderdale, FL – USA

orcid_id14.png https://orcid.org/0000-0001-6496-6275

José Daniel Osorio, Department of Surgery, Universidad del Valle, Cali, Colombia

orcid_id14.png https://orcid.org/0000-0003-0800-3284

Mónica Guzmán-Rodríguez, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile.

orcid_id14.png https://orcid.org/0000-0002-5515-263X

Luis Fernando Pino, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Hospital Universitario del Valle, Cali, Colombia.

orcid_id14.png https://orcid.org/0000-0002-1179-2854

Mario Alain Herrera, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Hospital Universitario del Valle, Cali, Colombia.

orcid_id14.png https://orcid.org/0000-0002-4526-7636

Adolfo González-Hadad, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Hospital Universitario del Valle, Cali, Colombia. Centro Médico Imbanaco, Cali, Colombia.

orcid_id14.png https://orcid.org/0000-0001-5862-4906

José Julian Serna, Universidad Icesi, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Fundación Valle del Lili. Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Hospital Universitario del Valle, Cali, Colombia.

orcid_id14.png https://orcid.org/0000-0001-9829-8930

Alberto Garcia, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Cali, Colombia. Division of Trauma and Acute Care Surgery, Department of Surgery. Fundación Valle del Lili. Cali, Colombia. Universidad Icesi, Cali, Colombia.

Federico Coccolini, Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy

orcid_id14.png https://orcid.org/0000-0001-6364-4186

Fausto Catena, Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy.

orcid_id14.png https://orcid.org/0000-0001-5558-9965

Salcedo, A., Ordoñez, C. A., Parra, M. W., Osorio, J. D., Guzmán-Rodríguez, M., Pino, L. F., Herrera, M. A., González-Hadad, A., Serna, J. J., Garcia, A., Coccolini, F., & Catena, F. (2024). Damage control for renal trauma: the more conservative the surgeon, better for the kidney. Colombia Medica, 52(2), e4094682. https://doi.org/10.25100/cm.v52i2.4682 (Original work published June 6, 2021)

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Received 2021-01-05
Accepted 2021-05-10
Published 2024-04-26