Nephrectomy at the University of Port Harcourt Teaching Hospital: a ten-year experience.

The case records of patients who had nephrectomy from 1989 to 1998 were retrieved. Data extracted for analysis included age, sex, clinical features, indications for nephrectomy, post-operative complications and histological findings. Thirty-four unilateral nephrectomies in 21 males and 13 females were done. The patients were aged between 1.5 to 75 years. The predominant presenting features were abdominal pain (76.5%), abdominal mass (70.6%), haematuria (61.8%) and weight loss (47.1%). Diagnostic investigations were intravenous urography and renal ultrasound scan. The major indications for renal exploration included non-functioning kidney and renal mass suspected to be carcinoma. The histopathological findings included renal malignancy 23 (67.6%), hydronephrosis 6 (17.6%) and renal infections 3 (8.8%). The male/female ratio in nephrectomy for malignancy was 1:1.09. Renal trauma was the indication in only one patient. Non-functioning kidneys on intravenous urography (IVU) occurred in both malignant and infective lesions. Hypertension was found in 9 patients preoperatively. It resolved in 7 patients after operation. The histological finding in one kidney differed from what was assumed at operation. Follow-up USS showed compensatory hypertrophy in the remaining kidneys. Post-operative sepsis occurred in 4 patients. One of these was a retroperitoneal abscess. Two patients with huge tumours died on the operating table. Two died from sepsis. Four patients died from metastatic disease within two years after operation. Malignancies constituted the commonest indication for and commonest cause of mortality in nephrectomy. Antibiotics prophylaxis is advocated. All nephrectomy specimens should be subjected to histopathological examination.