Radical Nephrectomy

What is a nephrectomy?

A nephrectomy is the surgical removal of a kidney, or part of a kidney. Removal of an entire kidney by itself is called a simple nephrectomy. If only part of your kidney is removed, that’s called a partial nephrectomy.

“Nephro” means “kidney” while “ectomy” means “removal.”

What is a radical nephrectomy?

In a radical nephrectomy the entire kidney is removed, along with the fat surrounding it. In some cases, the adrenal gland and lymph nodes around the kidney are also removed.

What do the kidneys do?

You have two kidneys, one on each side of your spine, in the back of your abdomen. Although you are born with two kidneys, you can live with only one, as long as it is functioning. Your kidneys cleanse your blood of toxins and change the waste into urine. They also keep your electrolytes and water content constant and secrete some essential hormones.

Who needs a nephrectomy?

This surgery is necessary if you have kidney cancer, other kidney diseases or injuries, or because your kidney is getting donated for transplant.

Is the procedure outpatient or inpatient?

A radical nephrectomy is an inpatient procedure. You will have to stay in the hospital for one to seven days.

What happens before a radical nephrectomy?

In the days before your operation, blood samples will be taken to tell your blood type in case you need a transfusion. Your healthcare provider might ask you to stop taking certain medications such as blood thinners. You will recover more quickly and are less likely to have a complication after surgery if you don’t smoke. You will be asked to not eat or drink after midnight the night before the surgery. Your healthcare provider will give you instructions about any of your medicines that you should take the day of the surgery.

How is a radical nephrectomy done?

Radical nephrectomies can by “open” or laparoscopic surgery. In an open surgery, there is one incision or opening. Laparoscopic surgeries are done with several smaller incisions. The surgeon uses an instrument called a laparoscope, which has a tiny camera on the end, to do the surgery. When the surgeon is ready to take out the kidney, he or she will make one of the cuts bigger.

Laparoscopic procedures, which also are called minimally invasive surgeries, are now more common than open procedures. However, for larger tumors, for more complex cases, or whenever clearing out all the lymph nodes is required, an open procedure is often still the best approach.

Will I be asleep during the radical nephrectomy?

Both laparoscopic and open nephrectomies are done under general anesthesia, meaning that you will be asleep during the operation.

What are the risks or complications of this procedure?

Like all surgeries, a radical nephrectomy surgery can cause infection, bleeding, post-operative pneumonia, post-operative wounds and, rarely, an allergic reaction to the anesthesia.

If your remaining kidney doesn’t function properly or has a disease, it may fail.

How should I care for the area once I’m home?

Your healthcare provider will give you specific instructions about how to take care of yourself after your surgery.

What happens after a radical nephrectomy?

When you’re out of surgery, your healthcare team will closely monitor your blood pressure and other body functions. You will be treated with pain medication. Shortly after surgery you will be asked to get out of bed and walk. This promotes healing and normal physical functions and also reduces the chance of some complications, including pneumonia. You might, for a short time, have a catheter (a thin, flexible tube) that will drain urine from your bladder.

How long does it take to recover from a radical nephrectomy?

Full recovery, including the ability to lift and engage in strenuous activities, may take up to six weeks.

What is the long-term outlook for a person who has had a radical nephrectomy?

Kidneys are important because they filter waste and excess water out of your body by making urine, and help to regulate your blood pressure. If both kidneys are removed, you will need a transplant or dialysis.

If you still have one healthy kidney, it can typically do everything you need it to do. Your healthcare provider might make dietary suggestions and recommend that you exercise and have regular checkups. If you take part in contact sports, you should discuss this with your healthcare provider because it is very important to protect the remaining kidney.

If a kidney is removed in childhood, there is a possibility of some loss of kidney function much later – usually at least 25 years later. However, this is usually mild and does not affect your lifespan.

When should I see my healthcare provider?

After your surgery your remaining kidney will need to be tested every year. Tests will include a urine test and blood pressure check. If protein is in the urine, that may mean that there’s something wrong with your remaining kidney. Every few years you’ll have to test your kidney functions, measuring the creatinine and glomerular filtration rate (GFR).