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Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

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Indications for nephrectomy in children: what has changed?

F T Hammad¹, V Upadhyay

¹Department of Paediatric Surgery and Urology, Starship Children's Hospital, Auckland, New Zealand.

Journal of Pediatric Urology

|October 25, 2008

Summary

Pediatric nephrectomies, including partial procedures, significantly increased from 1990-2001. This rise is linked to improved management of conditions like Wilms' tumor and multicystic dysplastic kidney (MCDK), with fewer surgeries for PUJ obstruction.

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Area of Science:

Pediatric Urology
Pediatric Surgery
Renal Pathology

Background:

Nephrectomy indications in children have evolved over time.
Understanding trends in pediatric kidney surgery is crucial for optimizing patient care.
Previous studies have highlighted varying reasons for nephrectomy in pediatric populations.

Purpose of the Study:

To review the indications for nephrectomy in children.
To analyze trends in pediatric nephrectomy between 1990 and 2001.
To compare nephrectomy rates and indications in two distinct periods within the study timeframe.

Main Methods:

Retrospective review of 206 pediatric nephrectomies.
Data collected from Starship Children's Hospital, Auckland, New Zealand.
The 12-year study period was divided into two halves for comparative analysis.

Main Results:

Total annual nephrectomies significantly increased, as did partial nephrectomies.
Multicystic dysplastic kidney (MCDK), Wilms' tumour, and vesico-ureteric reflux (VUR) were primary indications.
A significant decrease in nephrectomies for pelvi-ureteric junction (PUJ) obstruction was observed in the latter period.

Conclusions:

The overall number of pediatric nephrectomies, including partial nephrectomies, has risen.
Decreased nephrectomies for PUJ obstruction may reflect improved prenatal diagnosis and management of hydronephrosis.
The proportion of nephrectomies for Wilms' tumour, MCDK, and VUR remained stable.