“Nephrectomy unmasked: A nephrectomy case series through histopathology and hurdles”

Abstract

Nephrectomy remains a cornerstone procedure in the management of various renal pathologies, both benign and malignant. This case series emphasizes the unusual pathological entities and intraoperative complexities faced during nephrectomy.  This case series aims to analyse the clinical indications, intraoperative findings, postoperative outcomes, and complications among patients who underwent nephrectomy at our hospital over the past 3 months.

Materials and Methods: We have done retrospective observational study of 15 patients who underwent nephrectomy for both benign and malignant conditions between June 1, 2025 and August 30, 2025 at Department of Urology – at our hospital. We had collected socio-demographics data, clinical details (presenting symptoms, Preoperative CT scan findings, site of disease), intraoperative findings (operative time, blood loss, surgical approach, intraoperative complications), postoperative complications, mean hospital stay duration and histopathology report. We have done follow up of patient for 3 months postoperatively.

Results: Among 15 patients (mean age-48.8 years), 9 patients (60%) underwent surgery for benign indication and 6 patients (40%) underwent surgery for malignant disease. A total of 8 patients (53.3%) underwent surgery with laparoscopic approach and 7 patients (46.7%) were underwent surgery with open approach (3 patients were converted to open surgery. Mean operative time was 160 minutes with average blood loss of 110 ml. Mean hospital stay was 4.2 days (range 3-9 days). Post operative wound infection was seen in 2 patients. We had discussed cases with xanthogranulomatous pyelonephritis, communicating ruptured hydatid cyst, mixed epithelial and stromal tumour, leiomyosarcoma of kidney, renal transitional cell carcinoma in nonfunctioning pyonephrotic kidney. We have managed two cases of duodenal perforation occurring intraoperatively during right nephrectomy

Conclusion: Even in the minimally invasive era, open nephrectomy retains a vital and irreplaceable role. In our experience, judicious and patient-centered decision of timely conversion to open surgery ensures safety, complete disease control and favourable perioperative outcomes. In the current era, open nephrectomy continues to complement minimally invasive approaches rather than compete with them.