Kidneys may be damaged for a variety of reasons, including blockage of the urinary tract or various diseases such as kidney cancer. A nephrectomy procedure surgically removes non-functioning kidney tissue and can be either complete or partial.
What is it?
When the kidney is significantly damaged, a nephrectomy is performed to remove the nonfunctional portion of the kidney or entire kidney, depending on the extent of the damage. Donor nephrectomy occurs when a healthy kidney is surgically removed to conduct a transplant to a needing recipient. Nephrectomies are a prominent course of treatment for kidney cancers. Kidney cancer creates tumors within the kidney that need to be removed to prevent the spread of disease. If the cancer has already metastasized (spread to other locations), removing the source of the tumor in the kidney is performed to increase the chance of survival. For this reason, kidney cancer patients will likely undergo a nephrectomy, or in more severe cases, a radical nephrectomy in which the kidney, adrenal gland, and surrounding fatty tissue are removed.
What should I do to prepare?
Depending on the patient’s needs, the surgery and subsequent hospital stay may range from a few days to more than a week. Talking with your doctor about the duration of the hospital recovery can be beneficial. Additionally, the patient should refrain from taking blood thinners a week before the surgery because these medications increase the risk of surgical complications. The patient should discuss the use of blood thinners with their doctor based on his or her personal health needs since some may require them for stroke prevention. Patients cannot eat or drink during the evening before surgery to avoid complications with anesthesia such as aspiration. When a patient is put under anesthesia, food in the stomach may be expelled into the lungs. Some patients are urged to switch to an all-liquid diet one or two days in advance of the procedure. The recovery time can vary widely (especially when complications occur), so it is important to notify schools and employers as needed.
What happens during the process?
General anesthesia, the complete sedation of a patient, is used during a nephrectomy. This surgery can be performed as an open nephrectomy or a laparoscopic nephrectomy. In an open nephrectomy, the surgeon makes one large incision near the ribs to gain access to the kidney. In some cases, the doctor may need to remove a rib to better access the kidney. During laparoscopic surgery, several smaller incisions are made near the same area to allow for instruments to be inserted into the abdominal cavity. These tools include a camera that helps the surgeon see and perform the nephrectomy in a minimally invasive manner.
What are the risks and potential complications?
Nephrectomy includes risks, which include, but are not limited to, infection, bleeding, blood clots, adverse reactions to anesthesia, damage to adjacent organs, pneumothorax, leakage of urine, incisional hernia, kidney failure, high blood pressure, chronic kidney disease, and decreased kidney function.
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