Process improvement in trauma: compliance with recommended imaging evaluation in the diagnosis of high-grade renal injuries.

Background: Appropriate imaging in renal trauma can avoid delayed recognition of collecting system injuries, allowing for prompt intervention and less morbidity. Current recommendations include obtaining abdominal and pelvic computed tomographic scans with intravenous contrast, followed by excretory images for high-grade injury or perinephric fluid. The purpose of this study was to evaluate compliance with this recommendation among adult Level I trauma centers in Utah.

High grade renal injuries: application of Parkland Hospital predictors of intervention for renal hemorrhage.

Purpose: Investigators from Parkland Hospital proposed substratification of the AAST (American Association for the Surgery of Trauma) grading scale based on 3 risk factors, including active vascular extravasation, a medial laceration and a perinephric hematoma of greater than 3.5 cm. We hypothesized that these characteristics would also be associated with intervention for renal hemorrhage in our large trauma series.

Low quality of evidence for robot-assisted laparoscopic prostatectomy: results of a systematic review of the published literature.

Background: Robot-assisted laparoscopic prostatectomy (RALP) is displacing radical retropubic prostatectomy as the gold standard surgical approach for clinically localised prostate cancer in the United States and is also being increasingly used in Europe and other parts of the world. This trend has occurred despite the paucity of high-quality evidence to support its relative superiority to more established treatment modalities.

Objective: We performed this study to critically assess the quality of published evidence on RALP to support this major shift in practice patterns.