An audit of nephrectomy: A prospective study in a tertiary care hospital in Eastern India

Abstract

Nephrectomy means surgical removal of irreversibly damaged kidney by various disease processes, injury and congenital anomalies or en block removal of kidneys along with renal tumors.Objective of the study is to gather information and analyze nephrectomies performed at in a tertiary care hospital of Eastern India. A prospective observational study of nephrectomies performed during three years from April 2012 to March 2015 in a tertiary care hospital of Eastern India regarding their demographic study, clinical presentation, indications, postoperative complications and histopathological report.A total of 106 nephrectomies were performed during the study period. The male to female ratio was 1.3:1 (60:46). Left sided nephrectomies were more common than right side 1.3 :1 (60:46). The indications were renal malignancy in 57.5 % (61) cases others were benign conditions 42.5% (45) leading to non -functioning or poorly functioning kidneys. In the benign conditions, renal stone 22 (48.9%), neglected ureteropelvic junction obstruction 11(24.4%), chronic pyelonephritis 5 (11.1% ), renal tuberculosis 4 (8.9%), polycystic kidney disease 2(4.4%), renal trauma 1(2.2%). Malignant diseases were more common in male and benign diseases were more common in females. Benign conditions were more common in younger age group than malignant conditions which were more common in older age group. Nephrectomies in malignant conditions had a higher rate of complications than benign conditions. One patient in malignant group died in immediate postoperative period and one patient of benign group died in early postoperative period (<7 days) with overall 30 days mortality rate was 1.89%. In our study nephrectomies were performed more in malignant diseases than benign diseases. The mean age of patients undergoing nephrectomies for benign conditions were relatively younger than the mean age of patient undergoing nephrectomies with malignant tumours. There was a higher rate of post-operative complications in malignant tumours than benign diseases but there was no difference in overall mortality.