Cedric Lebacle

Origin and nature of pelvic ureter innervation

Innervation of the pelvic ureter traditionally comes from the pelvic plexus. This innervation is independent: adrenergic and cholinergic. The purpose of this study was to describe more precisely the origin and nature of its innervation (adrenergic, cholinergic, nitrergic, and somatic).

Evaluation of axitinib to downstage cT2a renal tumours and allow partial nephrectomy: a phase 2 study

To evaluate the ability of neoadjuvant axitinib to reduce the size of T2 renal cell carcinoma (RCC) for shifting from a radical nephrectomy (RN) to a partial nephrectomy (PN) indication, offering preservation of renal function.

PD63-08 EARLY MOBILIZATION IS SAFE AFTER RENAL TRAUMA : A MULTICENTER STUDY

does not include other potentially important factors such as devitalized renal fragments, laceration location and perinephric hematoma characteristics. The objective of this study is to examine predictors of urologic intervention in the setting of blunt renal trauma. METHODS: The Alberta Trauma Registry was used to identify renal trauma patients at the University of Alberta from October 2004December 2014. Penetrating trauma and patients without complete datasets were excluded from analysis. Hospital records and diagnostic imaging were reviewed to identify the need for intervention related to the renal injury including ureteral stenting, percutaneous drainage, angiographic embolization, nephrectomy or renorraphy. Clinical and radiographic factors examined included patient age, gender, length of stay, ISS, AAST-OIS grade, laceration length/number, perinephric hematoma characteristics (number, length, location, area), intravascular contrast excretion (ICE) and devitalized segment status. Descriptive statistics and binary logistic regression were performed where appropriate. RESULTS: 328 patients with blunt renal trauma met study criteria. Mean patient age was 37.0 years with a mean ISS of 31.7. 27 patients (8.2%) required a total of 31 interventions including ureteral stenting (38.7%; 12/31), angiographic embolization (32.3%; 10/31), nephrectomy (22.6%; 7/31), renorraphy (3.2%; 1/31) and percutaneous drainage (3.2%; 1/31). On univariate analysis AAST grade (p<0.001), hematoma diameter (p<0.001), hematoma area (p<0.001), ICE (p<0.001), laceration length (p<0.001), laceration number (p<0.001), devitalized fragment presence (p<0.0001) and degree of devitalization (p<0.001) were associated with the need for intervention. On multivariate regression analysis only AAST grade (p<0.001; O.R. 69.4; 95% C.I. 6.4-748.3), hematoma diameter (p1⁄40.004; O.R.1.5; 95%C.I. 1.11.9) and/or hematoma area (p1⁄40.012; O.R. 1.03; 95% C.I. 1.01-1.06) remained associated with the need for intervention. CONCLUSIONS: Although the AAST-OIS is strongly associated with the need for urologic intervention, perinephric hematoma diameter and area are also independently associated with this occurrence. Perinephric hematoma size should be considered during clinical decision-making and should be incorporated into a revised injury grading system.

MP79-02 LONG-TERM COMPLICATIONS OF RENAL TRAUMAS: A MULTICENTER STUDY

Ines Dominique*, Lyon, France; Gaelle Fiard, Grenoble, France; Xavier Matillon, Lyon, France; Benjamin Pradere, Tours, France; Charles Dariane, Paris, France; Lucas Freton, rennes, France; Jonathan Olivier, Lille, France; Cedric Lebacle, Paris, France; Clementine Millet, Clermont Ferrand, France; Quentin Langouet, Orleans, France; Paul Panayatopoulos, Angers, France; Reem Betari, Amiens, France; Ala Chebbi, Rouen, France; Thomas Caes, Lille, France; Pierre Marie Patard, Toulouse, France; Francois Xavier Madec, Nantes, France; Francois xavier Nouhaud, Rouen, France; Xavier Rod, Nantes, France; Martine Hutin, Montpellier, France; marina ruggiero, Paris, France; Axelle Bohem, Tours, France; jerome rizk, lille, France; Kerem Guleryuz, Caen, France; Benoit Peyronnet, Rennes, France

PD63-04 ROLE OF REPEAT IMAGING IN RENAL TRAUMA MANAGEMENT : RESULTS OF A FRENCH MULTICENTRIC STUDY (TRAUMAFUF)

INTRODUCTION AND OBJECTIVES: The majority of patients with renal trauma are managed conservatively regardless of grade of injury once they are stable with resuscitation. However, it is not known what happens to the function of the affected kidney following initial loss due to trauma. METHODS: In this prospective study conducted from July 2014 to December 2015 patients with unilateral renal injury and contra-lateral normal kidney were included. Their renal injury was graded according to American Association for the Surgery of Trauma. They underwent first DMSA renal scan within 7 days and second DMSA scan 3 months after trauma for assessment of early and delayed relative function of injured kidney respectively. Patients requiring any surgical and radiological intervention were excluded from the study. RESULTS: Total 32 patients fulfilled the inclusion and exclusion criteria and completed the study. The mean early relative function of the injured kidney (35.7 15.8 %) improved significantly at 3 months (39.6 17.7%, p < 0.001). When we considered grade I to grade III as low grade we observed that the improvement was significant in kidneys with low grade injury (from 46.1 3.2% to 50.4 2.7%, p < 0.01) and grade IV injury. There was no improvement of function of kidney with grade V injury (Table I). The preserved function and improvement of function was associated with low grade injury, low degree of parenchymal loss and no vascular injury (p<0.01, Table 2). On multivariate analysis only vascular injury was associated with no significant improvement in function. The relative renal function improved in 25 patient remained almost the same in 3 patients and decreased in 4 patients. Significantly a high proportion of kidney with high grade injury, more than 50% of parenchyma loss and vascular injury had loss of relative function more than 5 %. CONCLUSIONS: Retained renal function following conservative management depends on grade of renal injury, degree of parenchymal loss and vascular injury. The improvement of function of injured kidney occurs with passage of time in the majority except those with vascular injury. Source of Funding: none

MP72-19 PHASE II STUDY OF AXITINIB FOR DOWNSTAGING CT2A TO CT1 RENAL TUMORS FOR ALLOWING PARTIAL NEPHRECTOMY (AXIPAN)

Cedric Lebacle*, Le Kremlin-bicetre, France; Jean Christophe Bernhard, Bordeaux, France; Karim Bensalah, Rennes, France; Herve Baumert, Paris, France; Herve Lang, Didier Jacqmin, Brigitte Duclos, Strasbourg, France; Alain Ravaud, Bordeaux, France; Brigitte Laguerre, Rennes, France; Laurence Albiges, Villejuif, France; Armelle Arnoux, Le Kremlin-bicetre, France; Bernard Escudier, Villejuif, France; Jean Jacques Patard, Le Kremlin-bicetre, France