INDICATIONS FOR AND COMPLICATIONS OF NEPHRECTOMY CASES AT SPHMMC, ADDIS ABABA, ETHIOPIA

Abstract

Summary BACKGROUND: Nephrectomy is a standard urological procedure for malignancy of kidneys and upper urinary tract therapeutic, and for damaged kidneys with little or no contribution to the overall renal function. OBJECTIVE: The objective of the study is to determine the indications for and complications of nephrectomy cases in the Saint Paul’s Hospital Millennium Medical College. METHODS: A cross-sectional hospital based study was employed at St. Paul’s Hospital Millennium Medical College. Data was collected from charts retrieved from operation logbooks and pretested questionnaire was used. All charts of patients for whom nephrectomy done at SPHMMC during the study period which fulfill inclusion criteria were included in the study. Data obtained was sorted, organized, analysed using SPSS version 21.00 software. Independent variables include Age, Sex, clinical presentations whereas dependent variables includes indications and postoperative complications. RESULTS The total number of nephrectomies performed during the study period was 82. Out of which seventy one charts of patients with nephrectomies were included in this study. There were charts of 41(57.7%) males and 30 (42.3%) females with the male to female ratio of 1.3:1. The majority of patients for whom nephrectomy done were between the ages of 15- 30 (32.4%) The clinical presentations of patients for whom nephrectomy was done: flank pain, pyrexia and hematuria ( 31%),flank pain, pyrexia, LUTS and hematuria (19.7%). Nephrectomy performed for benign conditions (66.2 %) was the leading followed by malignant conditions (33.8 %).Complications of nephrectomy varied according to the indication, being higher in patients with malignancies (11.1%). Superficial surgical site infection was the leading complication among study subjects (8.5%) followed by hospital acquired pneumonia (4.2%). VI CONCULION: There is a higher rate of nephrectomy performed for benign conditions in SPHMMC (66.2%). Late presenting obstructive uropathy due to PUJO and stone causing loss of renal function was common in our study. Taking results of the studies done in other developing countries, we can conclude that still benign conditions of the kidney are the leading reasons for nephrectomy in developing countries. RECOMMENDATION: This study suggests the need of dire urgency to provide better health services at basic level and increase in awareness by education to decrease the rate of nephrectomy for preventable conditions like renal stone disease and early intervention for patients with UPJO. We also recommend further study on postoperative conditions and complications of the procedure on the patients who underwent nephrectomy.