title: Non operative management of renal gunshot wounds.
abstract: OBJECTIVE
  To analyze the experience of nonoperative management (NOM) of renal injuries caused by a firearm projectiles (FAP) in the right thoraco-abdominal region in patients with hemodynamic stability and no signs of peritoneal irritation, highlighting the assessment of the safety of this approach.
  
  
  METHODS
  This was a prospective study with patients sustaining injuries by FAP in the right thoraco-abdominal region and kidney lesions, treated at the João XXIII Hospital (FHEMIG) in Belo Horizonte, from January 2005 to December 2012. Inclusion criteria were: hemodynamic stability, renal morphofunctional study by CT and no signs of peritoneal irritation.
  
  
  RESULTS
  A total of 128 patients met the inclusion criteria of the protocol and underwent NOM for right thoraco-abdominal injury by FAP. Of these, 37 (28.9%) had renal injuries. Trauma indexes: RTS 7.8, ISS16, and TRISS 99%. Lesions grade II and grade III were the most frequent. The most commonly associated intra-abdominal injury was of the liver, present in 81.1% of cases. Two patients (5.4%) had failed nonoperative treatment.
  
  
  CONCLUSIONS
  The nonoperative treatment of such renal lesions, when properly indicated, has a high success rate, low complication rate and increases the chance of renal preservation. It is safe for well-selected patients in trauma centers with adequate infrastructure, experienced professionals and use of a specific protocol.
authors.forename: Bruna Pozzi
authors.initials: BP
authors.lastname: Cesar
authors.forename: Sizenando Vieira
authors.initials: SV
authors.lastname: Starling
authors.forename: Domingos André Fernandes
authors.initials: DA
authors.lastname: Drumond
mesh_terms: D005260:Female; D006801:Humans; D007668:Kidney / Q000293:injuries*; D008297:Male; D011446:Prospective Studies; D014948:Wounds, Gunshot / Q000628:therapy*; D055815:Young Adult