Kidney & Nephrology

Radical Nephrectomy

Description

A radical nephrectomy is when the kidney is removed through surgery. This is most regularly favored for treating kidney cancer. Radical nephrectomy consists of removing the complete kidney, along with a section of the tube leading to the ureter, the adrenal gland and the greasy tissue adjoining the kidney. 

The sign for radical nephrectomy is a clinically localized solid renal mass in a patient with a normal contralateral kidney. Generally speaking, radical nephrectomy is done for those patients who have not uncontrollable pain or life-threatening hemorrhage that leads to conventional treatment.

A radical nephrectomy can be done in both the open and laparoscopic manner. Open surgery is completed by making a cut on the patient’s side, abdomen or lower back while the kidney is removed. For performing the operation an incision is made on the side or on the front, just below the rib cage, thus allowing the surgeon to systematically inspect the kidney and the surrounding tissue for any possible tumor that is spread. To entirely remove cancer, the kidney, adrenal gland and the lymph nodes around the kidney are removed. It generally takes two hours to perform this operation.

Treatment Complications:

Roughly 20 percent of patients who go through radical nephrectomy cultivate postoperative complications and the operative mortality rate is around 2 percent. Intraoperative complications contain injury to any gastrointestinal organs (e.g., liver, spleen and pancreas) or to any major blood vessels (e.g., aorta and inferior vena cava). The outcome of pleural injuries is pneumothorax.

Postoperative complications consist of secondary hemorrhage from the renal pedicle or any unrecognized injury, atelectasis, ileus, both superficial and deep wound infections, temporary or permanent renal failure, and incisional hernia.

The other well-recognized systemic complications consist of myocardial infarction, congestive heart failure, pulmonary embolism, cerebrovascular accident, pneumonia, and thrombophlebitis.

Post Operative Care

After the operation has happened the patient will be taken to the recovery room until the patient is awake and the important signs like blood pressure, pulse and respiration are steady. If the patient feels any pain medications will be provided which will be of relief to the patient. There are times when some patients will be required to stay in the Intensive Care unit while the others will be relocated to a regular hospital room.

Most patients will not have a bowel movement for some days after surgery. Stool softeners are given while in the hospital and patients should ask for a laxative if they have not had a bowel movement within 1 week of the surgery. The patient will have to call the doctor’s office to make an appointment for the post-operative check. The patient‘s first doctor visit after your surgery is generally scheduled for three (3) weeks after you leave the hospital.

However, even after surgery, the patient will need to be seen routinely in the clinic to make sure the cancer has not returned or to arrange further treatments. The patient should make sure that no follow-up appointment is missed.