A nephrectomy is the surgical removal of a kidney or part of a kidney. In some cases, a surgeon may remove a person’s kidney to treat certain kidney diseases, including kidney cancer. Removal of renal tumors can not only be an effective treatment option but also help prevent the cancer from spreading elsewhere in the body.
The kidneys are a pair of bean-shaped organs that remove waste products from the body, maintain balanced electrolyte levels, and regulate blood pressure. Kidney cancer is one of the
Surgery is often the main treatment for many types of kidney cancer. Depending on different factors, such as the stage and location of the cancer, a surgeon may remove part of a kidney, a whole kidney, a whole kidney plus surrounding tissue, or both kidneys.
In this article, we will discuss what a nephrectomy is, why a person may require one, and how to prepare for the surgery.
A person with kidney cancer may require a nephrectomy to remove a cancerous tumor. Surgical removal of the kidney is often the
The aim of surgery is to cure the cancer, which is possible if a surgeon can completely remove the tumor. Even if surgery is unlikely to cure the cancer, the operation can still be beneficial, as it can help prevent the growth and spread of the cancer and relieve symptoms.
This approach is a suitable option for many people, as most individuals can live healthy lives with one kidney.
A person may also receive other treatment options, which can include targeted therapy, immunotherapy, and chemotherapy.
A
Partial
As the name suggests,
A partial nephrectomy is typically the preferable option for early-stage kidney cancer or smaller tumors measuring less than
However, partial nephrectomy may require the expertise of an experienced surgeon. Further, it may not be suitable for larger tumors, multiple tumors, tumors in the middle of kidneys, or cancer that has spread to the lymph nodes or distant organs.
Radical
In a
While a radical nephrectomy may involve removing the adrenal glands, a surgeon may be able to leave them intact if the cancer is in the lower part of the kidney.
If the tumor has grown through the large vein in the kidney (the portal vein), which empties into the heart through another large vein (the vena cava), the surgeon
Surgeons can perform these surgeries using different methods, which can include:
Laparoscopy
A laparoscopic nephrectomy is a minimally invasive surgery — done while a patient is under general anesthetic — that involves the use of a laparoscope. This is a wand-like camera that the doctor passes through a series of small incisions in the abdomen. The doctor uses the laparoscope to view the abdominal cavity and remove the kidney, or part of it, through a small incision.
Typically, laparoscopic surgery carries lower risks of postsurgical complications. A patient may also heal faster, have a shorter hospital stay, and experience smaller incisions with this type of nephrectomy. However, it requires a very skilled surgeon to perform it.
Robot assisted
In this type of surgery, surgeons use a robotic assistant, known as a da Vinci Surgical Robotic System, to remotely perform the surgery. The robotic system can help control the surgical instruments with greater precision.
Both conventional laparoscopic and robot-assisted surgery use similar approaches, with the main difference being the use of handheld instruments versus robotic instrumentation that a surgeon operates from a remote console.
This approach also offers many advantages, but it requires a skilled surgeon trained to use the da Vinci Robotic System.
Open nephrectomy
A doctor will not typically suggest an open nephrectomy. However, in some cases, it may be the most suitable approach to safely remove the tumor.
In this procedure, the surgeon makes an incision in the center or side of the abdomen. They may need to remove a rib in some instances. The surgeon then cuts away the tube that carries urine to the bladder from the kidney, called the ureter. They also cut away blood vessels from the kidney and then remove the kidney before closing the incision.
Every surgery carries some risks. Potential risks of nephrectomy may include:
- hemorrhaging, or bleeding, which can require a blood transfusion
- allergic reactions to anesthesia
- infection
- postsurgical pneumonia
- kidney failure in the remaining kidney
In some cases, the surgery can even be fatal.
To prepare for a nephrectomy, a person may need to undergo some tests to ensure they are in a suitable condition to have the surgery. The tests may include:
- blood tests to check general health and kidney function
- a chest X-ray to check if the lungs are healthy
- an electrocardiogram to check heart health
Roughly a week before the operation, a person may have a preassessment appointment where they meet their healthcare team. This can be a good time for a person to ask any questions they may have about the surgery, so it may be advisable to prepare some questions beforehand.
The surgeon will advise the individual on when to arrive at the hospital and when to cease eating and drinking prior to the surgery.
Following a nephrectomy, a person will usually remain in the hospital for 1–7 days, depending on the type of surgery they receive.
When possible, it is important for a person to get out of bed and start walking to prevent blood clots and wake the bowels. Medical staff can assist with getting out of bed and will allow a person to start drinking fluids and slowly start eating solid food when appropriate.
When a person is discharged from the hospital, they will receive pain medication and stool softeners. The healthcare team will also provide instructions regarding any restrictions on activity or diet. Depending on the individual and type of surgery, recovery may take roughly 4–8 weeks. A doctor will also schedule a postoperative appointment.
Following a successful nephrectomy, most people can continue living normal, healthy lives with one kidney.
After surgery, a person will regularly attend checkups to monitor how the remaining kidney is functioning. A doctor will likely perform blood and imaging tests every 3–6 months during the first 2 years. A person should also have regular kidney function tests to check creatinine and glomerular filtration rate (GFR). A doctor will also check urine for protein, which may indicate some kidney damage.
To protect their remaining kidney, a person may wish to avoid sports and activities involving heavy contact or collisions. Most individuals with one kidney due to nephrectomy related to kidney cancer typically do not need to follow a special diet.
After a successful nephrectomy, it is possible for renal cancer to recur in the kidneys or the structures adjacent to the kidney. A doctor can remove the new tumor with a nephrectomy or other treatments, such as radiation therapy, chemotherapy, targeted therapy, immunotherapy, or some combination of these.
At present, researchers do not know enough about kidney cancer to provide guidelines for definitively lowering the risk of recurrence. However, adopting
- stopping smoking
- eating well
- exercising regularly
- maintaining a moderate weight
Some guidelines also recommend using immunotherapy for high risk individuals.
A nephrectomy is a type of surgery to remove part or all of a kidney. It is one of the main treatment options for kidney cancer. A surgeon can use different approaches depending on the size, type, and location of the renal tumor.
Depending on the type of surgery, a person may remain in the hospital for 1–7 days, and recovery may take 4–8 weeks. A person can usually live a long and healthy life with one kidney. After surgery, a person will attend regular checkups to ensure their kidney is healthy and functioning.