Analysis of 87 nephrectomies in a tertiary healthcare center in Nigeria.

Abstract

Background: Nephrectomy is one of the most frequently performed operations on the kidney. It is necessary for treatment of malignant as well as some benign renal conditions.

Methodology: This was a five-year retrospective review of all adult patients who had open nephrectomy in Lagos University Teaching Hospital, Lagos, Nigeria between January 2014 and December 2019. The cases were traced using clinic, ward and theatre records. The clinical and operative details of these patients were retrieved and analysed. Clinical information extracted included patients’ demography, clinical presentations, diagnosis, procedures performed, complications and the immediate treatment outcome. Data were analysed using SPSS for Mac Version 25.0.  Results were displayed in simple proportions using tables and charts.

Results: A total of 87 patients’ records were available for review. Age range was 15–76years with a mean and median age of 49.4±15 and 52 years respectively. Majority, 73(83.9%) of the patients presented with at least one symptom, whereas 14(17.7%) were asymptomatic. Loin pain was the commonest presentation in 72(82.8%). Indication for nephrectomy were benign in 28(32.2%) and malignant in 59(67.8%) patients. Overall, renal cell carcinoma was the most common indication for nephrectomy accounting for 59.8% of all nephrectomies. A total of thirty-one morbidities occurred in sixteen patients with a complication rate of 18.4% while transfusion rate was 40.2%. Reoperation and mortality rates were 2.3 and 3.4% respectively.

Conclusion: Malignant renal tumors are predominant indications for nephrectomy in our institution. Though associated with a high transfusion rate, open nephrectomy remains a safe procedure with a good short-term outcome.