Nephrectomy- A Histomorphological study in a tertiary Care Centre

Background: Kidney can be involved in various pathological processes, both neoplastic and non-neoplastic conditions, some of which may require its surgical removal- nephrectomy1. Simple nephrectomy is a common procedure in urological practice and it is indicated in patients with an irreversible damaged kidney resulting from symptomatic chronic infections, obstruction, calculus, severe traumatic injury and renal dysplasia2. RCC is not sensitive to chemotherapy and radiotherapy, and surgical resection- radical nephrectomy is recognized as a possible cure for kidney cancer 3. Radical nephrectomy (where the kidney, perinephric fat, surrounding lymph nodes, and ipsilateral adrenal gland are all removed together with the whole Gerota’s fascia4. Chronic pyelonephritis with hydronephrosis is the most common type of nephrectomy specimen for non-neoplastic conditions due to increase in the incidence of Pelviureteric Junction Obstruction (PUJO) by upper ureteric calculi, whereas in the neoplastic group, Renal Cell Carcinoma (RCC) is the most common, due to increase in the incidence in chronic smokers. Most of the patients with Chronic Pyelonephritis (CPN) lead to permanent and progressive damage to the renal parenchyma ending up with nonfunctioning kidney 5. Methods: A Cross-sectional retrospective study was conducted in the Department of Pathology, Osmania general hospital, Hyderabad, Telangana, India during January 2021 to December 2022 that evaluated 60 nephrectomy specimens along with clinical details given in case records of the patients during this period. Histopathological evaluation of both simple and radical nephrectomy specimens was done and results were analyzed. Result: In our study a total of 60 nephrectomy specimens had been grossed and representative sections submitted for histopathological examination. Of 60 nephrectomies, 11(18.3%) were radical nephrectomies done for renal cell carcinomas and remaining 49(81.7%) cases were simple nephrectomies. On histopathological examination of total 60 nephrectomies 47(78.3%) were non-neoplastic conditions and 13(21.7%) were neoplastic. The most common cause for nephrectomy in medical cases was chronic pyelonephritis with or without non-functioning kidney constituted about 78.9%. Conclusion: Histopathological evaluation of nephrectomy specimens plays a vital role in revealing underlying familial cystic diseases, chronic medical and also neoplastic conditions of the kidney.