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NEPHRECTOMY 

Nephrectomy is a surgical procedure in which either a part or the entire kidney is removed. It is performed to treat diseases, such as kidney cancer, end-stage renal disease etc. It is also performed to treat diseased or damaged kidney.

Types

  • Partial nephrectomy is the one in which only the damaged or diseased portion of the kidney is removed
  • Radical nephrectomy is the one in which entire kidney along with a part of the tube connecting to the urinary bladder is removed
  • Simple nephrectomy is a type of nephrectomy in which the entire kidney is removed
  • Bilateral nephrectomy is a type of nephrectomy in which both the kidneys are removed.

Need for the surgery

Nephrectomy may be required in the following conditions:

  • Kidney cancer
  • Kidney damage due to severe injuries, infection, kidney stones, etc.
  • Birth defects
  • Kidney removal from a donor for transplantation

Preparing for the surgery

It is better to be prepared in advance for nephrectomy to reduce anxiety and risks associated with the surgery. The following preparation is helpful:

Before undergoing the surgery, inform the doctor if there are any chances of pregnancy and also about the drugs which are currently in use. Considering these, the doctor may decide whether or not the surgery is suitable for the patient.

Few days before the surgery:

  • Blood tests may be performed to check the need for blood transfusion
  • Some of the drugs currently in use need to be discontinued as per the doctor’s advice. These mainly include aspirin, clopidogrel, warfarin, naproxen, etc.
  • Smoking should be stopped as it may interfere in the healing process

One day before undergoing surgery

  • Do not eat or drink anything the previous night, until the completion of the surgery
  • Take all the important drugs as advised by the doctor with a sip of water

Procedure

Nephrectomy is performed under general anesthesia and it may take around 2-4 hours depending on the type of surgery. It is done in different ways as follows:

  • Open surgery is performed by making a long incision (a cut) in front of the abdominal region and the kidney is removed. The post-surgical scars may take few weeks to fade away.
  • Laparoscopic surgery is a minimally invasive procedure in which small incisions are made in the belly to insert the video cameras and small surgical tools for the removal of the kidney. Recovery from a laparoscopic surgery is faster and does not cause much pain when compared to a open surgery.

After discussing the advantages and disadvantages of both the types of surgeries with the patient, the doctor may opt for the most appropriate surgery.

After the procedure

The patient may have to stay for about 2-7 days in the hospital depending on the type of surgery. Additionally,

  • A catheter will be inserted to drain the urine out
  • Special stockings or compression boots may be worn to prevent blood clots
  • There can be a discomfort or numbness at the site of surgery
  • Other symptoms the patient may develop are tiredness, constipation, diarrhea, nausea and headache
  • The patient is encouraged to sit on one side or walk slowly on the same day of the surgery
  • Pain medicines will be prescribed to relieve pain associated with the surgery
  • It is not advisable to have solid foods for the first 1-3 days. The dietician plans a diet for the patient, which may include more of fluids.

Post surgical care

It may take around 6 weeks to recover from the surgery. The below measures can help in faster healing process:

  • Avoid strenuous exercises for at least 6 weeks after the surgery
  • Follow dietary restrictions as suggested by the doctor
  • Perform breathing exercises to prevent pneumonia
  • Visit the doctor regularly to have a check on blood pressure, electrolytes, urinary protein levels, and glomerular filtration rate

Complications

The following are the risks associated with nephrectomy:

  • Blood loss from bleeding
  • Blood clots which can travel from the legs to the lungs
  • Infection of the surgical wounds, kidneys, bladder or lungs
  • The use of medicines such as anesthetics may cause reactions
  • At times the retained kidney may not work as efficiently as it was working earlier
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