Nephrotomy as a Surgical Approach for Renal Dioctophymosis in Eighteen Dogs.

Nephrotomy is a feasible, kidney-preserving surgical option for canine renal dioctophymosis when residual parenchyma is ultrasonographically confirmed.

This retrospective study evaluated open nephrotomy as a parenchyma-sparing surgical alternative to nephrectomy in 18 dogs diagnosed with right renal dioctophymosis caused by Dioctophyme renale, the giant kidney worm. Patient selection was guided by ultrasonographic evidence of residual renal parenchyma, emphasizing the importance of early diagnosis before complete parenchymal destruction. A paracostal approach was predominantly employed to optimize surgical exposure of the right kidney. Vascular occlusion was performed using a Rummel tourniquet, with ischemia time deliberately maintained under 20 minutes to minimize renal ischemic injury. Parasite removal was achieved successfully in all 18 cases, demonstrating technical feasibility of the procedure. Postoperative monitoring of serum creatinine revealed stable or improved values in evaluated patients, suggesting preservation of functional renal tissue. While nephrectomy remains the most commonly performed intervention for this condition, this study supports nephrotomy as a viable option in appropriately selected candidates. The authors highlight that ultrasonography is the diagnostic modality of choice, enabling identification of characteristic tubular structures within the renal parenchyma. Limitations include the retrospective design and absence of long-term follow-up data. The authors advocate for prospective studies to better define long-term renal outcomes and refine patient selection criteria. Earlier diagnosis may expand the pool of candidates suitable for this kidney-preserving approach, which is particularly relevant given the zoonotic significance of D. renale.

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