Ezomike Uchechukwu Obiora, Modekwe Victor Ifeanyichukwu, Ekenze Sebastian Okwuchukwu
Sub-Department of Paediatric Surgery, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku/Ozalla Campus, Enugu, Nigeria.
Paediatric Surgery Unit, Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
Malawi Med J. 2018 Jun;30(2):94-98. doi: 10.4314/mmj.v30i2.8.
Patterns of and indications for nephrectomy vary in different age groups, geographical locations and time periods. In some series nephrectomies were mainly for malignant conditions while in others they were predominantly for non-malignant conditions. Such data on patterns, indications, and outcomes of nephrectomy in children is limited in our environment.
To evaluate nephrectomy in childhood at the Sub-Department of Pediatric Surgery University of Nigeria Teaching Hospital, Ituku/Ozalla Enugu with a focus on pattern, indications, and outcome.
Medical records of all patients aged =16years who had nephrectomy from January 2007 to December 2016 were studied with emphasis on age, sex, side of nephrectomy, duration of symptoms before presentation, indication for nephrectomy, in-hospital complications, length of hospital stay, in-hospital mortality. SPSS version 15 was used for data entry and analysis.
There were 52 nephrectomies in 32 males and 20 females. They were for 35 malignant and 17 non-malignant conditions. Most of the malignancies were Wilms tumour (34/35) while non-malignant conditions were late-presenting pelvi-ureteric junction obstruction (9), large multi-cystic dysplastic kidneys (4), renal trauma with pedicle avulsion (1), posterior urethral valve with atrophic kidney (1), duplex system with nonfunctioning upper pole moiety (2). Mean age at nephrectomy was 5.10±3.66 years (range 7 weeks to 16 years); 59% of the nephrectomies were on the left and 41% on the right. Mean duration of hospital stay was 31.78±16.59 days (range 7-66 days). In-hospital mortality rate was 5.8%.
In our unit, nephroblastoma is the main indication for pediatric nephrectomy and were the only indications in females; neglected pelvi-ureteric junction obstruction was the major non-malignant indication and occurred only in males; most nephrectomies were done in the age range of 1-5 years; nephron-sparing nephrectomy, major morbidity, re-operation are uncommon and in-hospital mortality from nephrectomy is still high at 5.8%.
肾切除术的模式和指征在不同年龄组、地理位置和时间段存在差异。在一些系列研究中，肾切除术主要用于恶性疾病，而在其他研究中则主要用于非恶性疾病。在我们所处的环境中，关于儿童肾切除术的模式、指征和结果的此类数据有限。
评估尼日利亚大学教学医院伊图库/奥扎拉埃努古儿科外科分部的儿童肾切除术，重点关注模式、指征和结果。
研究了2007年1月至2016年12月期间所有年龄≤16岁接受肾切除术的患者的病历，重点关注年龄、性别、肾切除侧、就诊前症状持续时间、肾切除指征、住院并发症、住院时间、住院死亡率。使用SPSS 15版进行数据录入和分析。
共进行了52例肾切除术，其中男性32例，女性20例。手术针对35例恶性疾病和17例非恶性疾病。大多数恶性肿瘤为肾母细胞瘤（34/35），而非恶性疾病为晚期出现的肾盂输尿管连接部梗阻（9例）、巨大多囊性发育不良肾（4例）、肾蒂撕脱的肾外伤（1例）、后尿道瓣膜伴萎缩肾（1例）、重复肾伴无功能上极部分（2例）。肾切除时的平均年龄为5.10±3.66岁（范围7周至16岁）；59%的肾切除术在左侧，41%在右侧。平均住院时间为31.78±16.59天（范围7 - 66天）。住院死亡率为5.8%。
在我们科室，肾母细胞瘤是儿童肾切除术的主要指征，且是女性的唯一指征；被忽视的肾盂输尿管连接部梗阻是主要的非恶性指征，且仅发生在男性中；大多数肾切除术在1 - 5岁年龄组进行；保留肾单位的肾切除术、严重并发症、再次手术并不常见，肾切除术的住院死亡率仍高达5.8%。
