Radical nephrectomy

Overview

A nephrectomy is a surgical procedure aimed at removing a kidney or a portion thereof. There are different types of nephrectomies: a simple nephrectomy involves the removal of an entire kidney, whereas a partial nephrectomy targets only a section of the organ. In more extensive cases, such as a radical nephrectomy, the surgery includes the removal of not only the kidney but also the surrounding fat, and potentially the adrenal gland and nearby lymph nodes.

Humans are typically born with two kidneys located on each side of the spine in the lower abdomen. Despite having a pair, a person can live a healthy life with just one functioning kidney. The kidneys play a crucial role in purifying the blood by eliminating toxins, converting waste into urine, maintaining a balance of electrolytes and water, and releasing vital hormones.

Reasons for undergoing the procedure

This surgical procedure becomes essential in cases of kidney cancer, other kidney-related diseases or injuries, or when your kidney is being donated for transplantation.

Risks

Similar to all surgical procedures, a radical nephrectomy surgery carries potential risks, including infection, bleeding, post-operative pneumonia, post-operative wounds, and, in rare instances, an allergic reaction to anesthesia.

If your remaining kidney experiences dysfunction or is afflicted by a disease, there is a possibility of kidney failure.

Before the procedure

Before your surgery, your healthcare provider will take blood samples to determine your blood type, should a transfusion be necessary. You may be advised to discontinue certain medications, like blood thinners, to minimize surgical complications. Quitting smoking can also enhance your recovery speed and reduce the likelihood of complications. Additionally, you’ll be instructed to abstain from eating or drinking after midnight on the night before your surgery. On the day of the surgery, specific instructions regarding the intake of your regular medications will be provided by your healthcare provider.

During the procedure

Radical nephrectomies, the surgical removal of a kidney, can be performed through either open or laparoscopic (minimally invasive) techniques. Open surgery involves a single, larger incision, while laparoscopic surgery employs several smaller incisions and a laparoscope equipped with a camera to guide the procedure. During laparoscopic nephrectomies, one of the incisions may be enlarged to facilitate the removal of the kidney. Although laparoscopic surgeries have become more common due to their minimally invasive nature, open procedures are often preferred for larger tumors, more complex cases, or when complete lymph node removal is necessary. Both methods are conducted under general anesthesia, ensuring the patient is asleep and pain-free throughout the operation.

After the procedure

Following the surgery, your healthcare team will vigilantly monitor your blood pressure and other bodily functions. Pain medication will be administered to manage discomfort. Shortly after the surgery, you’ll be encouraged to leave the bed and take a walk. This not only supports the healing process and normal physical functions but also diminishes the risk of certain complications, such as pneumonia. Additionally, you may have a catheter (a thin, flexible tube) temporarily in place to drain urine from your bladder.

Outcome

Your doctor will provide detailed instructions on how to care for yourself post-surgery. A complete recovery, allowing for activities like lifting and strenuous engagement, may take up to six weeks.

The kidneys play a crucial role in filtering waste and excess water, producing urine, and regulating blood pressure. If both kidneys are removed, a transplant or dialysis becomes necessary. With one healthy kidney, normal functionality can be maintained. Your doctor may offer dietary recommendations, suggest regular exercise, and advise on regular checkups. For those participating in contact sports, discussing this with your doctor is crucial to safeguard the remaining kidney.

In cases where a kidney is removed during childhood, there is a potential for some loss of kidney function much later, typically at least 25 years afterward. However, this is generally mild and does not significantly impact lifespan.