Heminephrectomy in Adults: A Systematic Review with Cumulative Analysis

Abstract

Introduction: Duplex collecting system of the kidney is a relatively common abnormality, with the majority of symptomatic cases discovered in childhood. Treatment is commonly a heminephrectomy of the affected moiety. We aimed to conduct a systematic review of the literature to provide the best available evidence for heminephrectomy for duplex kidneys in the adult population.

Materials and methods: A literature search was conducted in September 2017 with no limitations being placed on language, region, date or publication type. Data were represented numerically and analysed cumulatively.

Results: Seven retrospective studies with 66 patients were included. Of which, 56/66 operations were performed laparoscopically, 5/66 were robot-assisted and 5/66 were open procedures. Complete resolution of symptoms was reported in 53/55 (96.4%) of patients in five studies providing outcome data. Of the 6 studies reporting complications, there were a total of 9 complications (9/62, 14.5%), however 5 of these were found to be in one study alone.

Conclusions: This review emphasises the scarcity of evidence for heminephrectomy in adults. Nonetheless, it has been shown that this operation may be effective in alleviating patients' symptoms in addition to being safe in experienced hands.

Keywords: Duplex; Heminephrectomy; Laparoscopic heminephrectomy; Laparoscopy; Moiety.