Analysis of Adult Nephrectomies at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

Abstract

Objective: To evaluate open nephrectomies performed in adults over a five year period at the Komfo Anokye Teaching Hospital (KATH) and to compare our experience with findings in the literature. Materials and Methods: This was a prospective, cross-sectional, hospital based study of all adults undergoing nephrectomy from October 2012 to September 2017 at KATH. We obtained data on patient demographics, clinical presentation, laboratory and imaging results, laterality of the disease, and indication for nephrectomy, complications and histopathology of nephrectomy specimen. The data was analyzed using PASW Statistics for Windows, Version 19.0. Chicago: SPSS Inc. Results: Thirty three (33) adult nephrectomies were performed over the study period. There were 18 males (54.50%) and 15 females (45.50%) with an age range of 16 years to 80 years. The modal age range for renal malignancies was 31-40 years accounting for 36.40% of adult nephrectomies. Flank pain (75.80%), haematuria (54.60%) and flank mass (51.50%) were the predominant presenting complaints. Malignant renal tumours accounted for 22 (66.70%) of the nephrectomies followed by neglected Pelvi-Ureteric Junction Obstruction (PUJO)-7 (21.20%); two (6.10%) nephrectomies were due to trauma and one (3.00%) for emphysematous pyelonephritis. Conclusion: Renal cell carcinoma constitutes the main indication for adult nephrectomy at KATH followed by neglected PUJO. Most of the patients with renal tumours were young and also presented late.

Study of 46 nephrectomies in rural India

“…The reported rates of nephrectomy for renal malignancies accounted for 66.70% of all indications from studies in Boateng et al at Ghana and by Kyei et al renal malignancy accounted for 54% of all nephrectomies from Nigeria and Norway were 67.3 and 68%, respectively. 10,11,13 In a recent series of adult nephrectomies from Nigeria, 63% cases were performed for malignant conditions of the kidney. 12 Beisland et al have also reported a change in the indications for nephrectomy in Norway during the last few decades, with an increase in the number of nephrectomies being performed for malignant conditions of the kidney.…”