Effect of Kidney Volume on the Results of Nephrectomy Performed for Xanthogranulomatous Pyelonephritis

Abstract

Aim This study aims to evaluate the results of patients we treated with nephrectomy due to Xanthogranulomatous pyelonephritis (XGP) and the effects of kidney volume on the results. Patients and methods Records of 22 patients who underwent nephrectomy due to renal masses at our clinic between January 2008 and May 2018 and whose pathology results indicated XGP were retrospectively evaluated. The computed tomography (CT) measurement of the kidney volumes of the patients was calculated as the product of the longest length, width, and height of the kidney. The mean kidney volume of the patients was calculated and the patients were distributed into two groups: those that presented volumes below average (Group 1) and above average (Group 2). The patients’ mean ages, operative duration, hospitalization days, differences in pre- and postoperative hemoglobin and creatinine levels, and postoperative complications were compared across groups. Results Group 1 consisted of 12 patients and Group 2 of 10 patients. The mean kidney volume of the patients was calculated as 33.4 cm 3 ± 26.0 cm 3 . The mean kidney volume of the patients was 15.8 cm 3 ± 9.9 cm 3 in Group 1 and 56.8 cm 3 ± 21.8 cm 3 in Group 2. There were no statistical differences between the two groups in terms of operative times, preop-postop hemoglobin (Hgb) levels and complications. Conclusion In cases where XGP is considered probable, the priority in preoperative CT must be to thoroughly evaluate the relationship of the kidney with the surrounding tissue and organs rather than to investigate the patients’ kidney volumes.

Xanthogranulomatous pyelonephritis: a systematic review of treatment and mortality in more than 1000 cases

“…Finally, 40 eligible studies were identified, comprising 1139 patients with XGP from 20 nations [3,4,5,6, (Table 1). All studies were retrospective, and only five were multicentre [20,21,29,37,50].…”

“…Three studies were excluded, with all three having both unclear mean/median patient age and failure to state number of deaths [12‐14]. Finally, 40 eligible studies were identified, comprising 1139 patients with XGP from 20 nations [3,4,5,6,15–50] (Table 1). All studies were retrospective, and only five were multicentre [20,21,29,37,50].…”

“…Where reported, upper urinary tract stones were present in 545 of 788 patients (69%) [3,5,6,16–18,20–24,26,27,30,31,33,36,38–44,46,47,49,50]. This included 214 of 450 patients (48%) with staghorn calculi.…”

“…3). Eighteen case series enrolled patients (462 total) undergoing nephrectomy via an unspecified approach [5,16,17,19,21,22,25,26,29,33,[36][37][38]41,44,[47][48][49], and another six works enrolled only patients (181 total) managed with laparoscopic nephrectomy [24,30,34,35,43,45]. When a laparoscopic approach was chosen and rates of intraoperative conversion to an open approach were reported, this occurred in 36 of 282 patients (13%).…”

Xanthogranulomatous pyelonephritis: Case series – Clinical, radiologic, therapeutic, and histological aspects

“…Described in 1916 by Schlagenhaufer,[ 1 2 ] xanthogranulomatous pyelonephritis is an uncommon type of chronic infectious pyelonephritis that evolves with a suppurative process and severe impairment of the renal function. Adult women and the elderly are most affected and are commonly associated with urinary tract obstruction and/or infection.…”