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Nephrectomy
Nephrectomy refers to a surgical procedure which involves the surgical removal of all or a part of the kidney. Nephrectomy is used as a treatment for kidney cancer, benign tumors or other kidney diseases that may have caused serious damage to a kidney. It is also performed for the removal of a healthy kidney from a donor for a transplant. There are three types of Nephrectomy:
- Radical nephrectomy- involves removing the entire kidney, along with the ureter (tube that connects the kidney to the bladder), adrenal gland, fatty tissue surrounding the kidney and lymph nodes. When both kidneys are removed, it is known as bilateral nephrectomy.
- Partial nephrectomy- in partial nephrectomy, only the diseased or injured part of the kidney is removed, leaving the rest of the healthy tissue in place. It is also called “nephron-sparing” surgery.
Kidney cancer or kidney disease may present with the following symptoms:
- Blood in the urine
- A lump in the side or the abdomen
- Anemia
- Fatigue
- Sudden and unexpected weight loss
- Pain in the side or lower back
- Loss of appetite
- Fever that does not go away for weeks
Kidney cancer or kidney disease can be diagnosed using the following diagnostic procedures:
- Medical history and physical exam- the doctor would check the patient’s medical for risk factors and symptoms. The doctor might look for the presence of a mass or lump in the abdomen near the kidneys.
- Urinalysis (urine tests)- the doctor would check for blood in the urine or other signs such as cancer cells in the urine.
- Blood tests- for a complete blood count and to test functioning of the kidneys
- Imaging tests- such as MRI, CT scan, PET scan and ultrasounds can help look for a lump or mass
- Intravenous pyelogram (IVP)- X-ray of the kidneys
There are two different approaches to surgery; open surgery and laparoscopic surgery.
- Open surgery- a single long incision is made in the front of the abdomen or the side of the abdomen. The ureter and the blood vessels connected to the kidney are cut off from it and the kidney is removed. The incision is then closed with stitches.
- Laparoscopic approach- in this procedure, the surgeon makes several small incisions. A device with a camera on one end, called a laproscope, is inserted through one of these incisions, the images from which can be seen on a monitor. Long, thin surgical devices are inserted through the other incisions to perform the surgery. The kidney is removed through one of these incisions. It is a less invasive technique as compared to open surgery.
As with any other major surgery, a nephrectomy may include the following risks:
- Bleeding
- Infection at the incision site
- Damage to nearby organs
- Allergic reaction to the anesthetic administered during surgery
- Post-operative pneumonia
The surgery is 2-4 hours long. The patient may have to stay in the hospital for 3-5 days. Symptoms like fatigue, nausea, diarrhea, constipation or headache may be experienced a couple weeks after surgery. The patient can get back to work 4-6 weeks post the surgery.
Nephrectomy Cost from trusted Hospitals in Bengaluru
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Nephrectomy
Nephrectomy refers to a surgical procedure which involves the surgical removal of all or a part of the kidney. Nephrectomy is used as a treatment for kidney cancer, benign tumors or other kidney diseases that may have caused serious damage to a kidney. It is also performed for the removal of a healthy kidney from a donor for a transplant. There are three types of Nephrectomy:
- Radical nephrectomy- involves removing the entire kidney, along with the ureter (tube that connects the kidney to the bladder), adrenal gland, fatty tissue surrounding the kidney and lymph nodes. When both kidneys are removed, it is known as bilateral nephrectomy.
- Partial nephrectomy- in partial nephrectomy, only the diseased or injured part of the kidney is removed, leaving the rest of the healthy tissue in place. It is also called “nephron-sparing” surgery.
- Simple nephrectomy- only the kidney is removed.
Symptoms
Kidney cancer or kidney disease may present with the following symptoms:
- Blood in the urine
- A lump in the side or the abdomen
- Anemia
- Fatigue
- Sudden and unexpected weight loss
- Pain in the side or lower back
- Loss of appetite
- Fever that does not go away for weeks
Diagnosis
Kidney cancer or kidney disease can be diagnosed using the following diagnostic procedures:
- Medical history and physical exam- the doctor would check the patient’s medical for risk factors and symptoms. The doctor might look for the presence of a mass or lump in the abdomen near the kidneys.
- Urinalysis (urine tests)- the doctor would check for blood in the urine or other signs such as cancer cells in the urine.
- Blood tests- for a complete blood count and to test functioning of the kidneys
- Imaging tests- such as MRI, CT scan, PET scan and ultrasounds can help look for a lump or mass
- Intravenous pyelogram (IVP)- X-ray of the kidneys
Treatment
There are two different approaches to surgery; open surgery and laparoscopic surgery.
- Open surgery- a single long incision is made in the front of the abdomen or the side of the abdomen. The ureter and the blood vessels connected to the kidney are cut off from it and the kidney is removed. The incision is then closed with stitches.
- Laparoscopic approach- in this procedure, the surgeon makes several small incisions. A device with a camera on one end, called a laproscope, is inserted through one of these incisions, the images from which can be seen on a monitor. Long, thin surgical devices are inserted through the other incisions to perform the surgery. The kidney is removed through one of these incisions. It is a less invasive technique as compared to open surgery.
Risks
As with any other major surgery, a nephrectomy may include the following risks:
- Bleeding
- Infection at the incision site
- Damage to nearby organs
- Allergic reaction to the anesthetic administered during surgery
- Post-operative pneumonia
After Procedure
The surgery is 2-4 hours long. The patient may have to stay in the hospital for 3-5 days. Symptoms like fatigue, nausea, diarrhea, constipation or headache may be experienced a couple weeks after surgery. The patient can get back to work 4-6 weeks post the surgery.
FAQ Section
Nephrectomy is a surgery in which part or whole of a kidney or both kidneys is removed. It can either be done as a laparoscopic surgery or an open one. When only the diseased or injured portion of the kidney is removed, it is known as partial nephrectomy. Removal of the whole kidney along with its ureter, the adrenal gland and the fatty tissue around the kidney is known as radical nephrectomy. Nephrectomy of both kidneys is known as bilateral nephrectomy. When a healthy kidney is removed from the person for donation purpose, it is known as donor nephrectomy.
Indications for a nephrectomy include
- A kidney tumour or cancer
- Acute trauma to the kidney
- Chronic infection in the kidney
- Renal Calculi (Kidney stones)
- Polycystic Kidney Disease (Clusters of cysts form in the kidneys enlarging them and reducing their functioning over time. It is an inherited disorder.)
- Hydronephrosis (Swelling of the kidney due to blockage in the ureter)
- CKD (Chronic Kidney Disease which causes the kidney to lose its function over time)
- ESRD (End Stage Renal Disease which is the last stage of CKD and involves complete failure of the kidney)
- Any such condition in which the doctor decides that kidney removal is the only viable option to tackle the condition
Apart from this, nephrectomy is undertaken for people who are donating their healthy kidneys.
The surgery itself lasts for 2-3 hours. You will be required to stay in the hospital for three days in case of laparoscopic surgery and up to 5 days in case of open surgery.
Recovery time is variable after discharge, but on average, patients take three weeks to recover from laparoscopic surgery and around six weeks from open surgery.
Yes, kidney tumor can be removed through nephrectomy. If the patient has some conditions due to which he/she cannot undergo surgery, then other means are used to tackle a tumor.
If the cancer is discovered at an early stage, chances of survival are very high. However, the more advanced cancer becomes, the lower the survival chances. If the doctor finds sarcomatoid features (these are an irregular, disorganized feature on the normal cancer cells as seen under a microscope) in the cancer cells, the cancer is said to be very aggressive
Complication of nephrectomy include –
- Infection
- Allergic reaction to anaesthesia and medications used during the surgery
- Post-operative pneumonia
- Haemorrhage which requires blood to be transfused
- Kidney failure in patients where the remaining kidney has lowered function or is diseased
- Injury to the neighbouring organs
Rarely has nephrectomy led to fatal consequences. The mortality rate of nephrectomy is around 2%.
There are absolutely no side-effects of living with one kidney. A person with kidney can live a healthy and long life. The worst that can happen is high blood pressure later in life and a very mild loss of function of the working kidney.
A normal diet is recommended after a kidney removal. You will be restricted to a liquid diet for 1-2 days after the surgery depending upon the doctor after which you can resume a normal diet. You should be careful about prescription and over the counter medications. Consult your doctor before taking any of these medications. Engage in a healthy diet and indulge physical activity in your daily schedule.
Recent studies have found that high protein intake and high sodium intake can be linked to CKD (Chronic Kidney Disease) and ESRD (End Stage Renal Disease). CKD is low functioning of the kidney which eventually leads to ESRD which is complete kidney failure. Thus, doctors might encourage you not to take a lot of proteins, especially not protein shakes etc. and to keep your sodium intake to a minimum.
Signs of kidney cancer include-
- Blood in the urine
- Lower back pain but only on one side without any injury sustained
- A lump on the side or lower back
- Loss of weight (which is not worked towards)
- Perpetual fatigue
- Fever that does not go away
- Loss of appetite
- Low RBC count (Anaemia)
Please remember that these symptoms might not be caused by kidney cancer but people with kidney cancer experience these conditions. You need to go to your doctor and get all the relevant tests done to be sure of what the conditions are.
Alcohol consumption has been found to cause problems with a healthy, fully functioning kidney. Although a few drinks here and there do not cause any problems, you are surviving on one kidney and you should not risk getting any kidney related problems. Thus, abstaining from alcohol is recommended, but one or two drinks at some party can be indulged.
People who are from countries which do not have adequate medical facilities do come to India for nephrectomy. These mainly include developing nations and underdeveloped nations. Since the cost of a nephrectomy is very less compared to other parts of the world, a lot of people come to India for cost-effective surgeries.
Generally, no. The type of problem will decide whether a nephrectomy is necessary or not. Almost all forms of kidney cancers except Lymphoma requires nephrectomy as the full procedure or part of the procedure. Your doctor is the person who will diagnose your condition and decide whether a nephrectomy will be helpful in tackling your condition. Procedures like Radiofrequency Ablation, Cryoablation, Anti-angiogenesis therapy, mTOR inhibitors therapy, and other targeted therapies, Arterial Embolization, Immunotherapy, Chemotherapy or Radiotherapy may be used to tackle cancer due to its nature or the patient’s inability to go under a surgery due to some condition.