Nephrectomy: Overview, Preparation, Procedure, Recovery, Risks, and Aftercare
In a nephrectomy, part or all of a kidney is removed surgically. It may be necessary for treating kidney cancer, severe kidney damage, or kidney transplantation. Depending on the condition of the patient and the surgeon's preference, nephrectomy can be performed using open surgery, laparoscopic surgery, or robotic-assisted surgery.
Preparation
In preparation for a nephrectomy, patients typically undergo the following steps:
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To determine whether a patient is eligible for surgery, a thorough medical evaluation is conducted, including laboratory tests, imaging studies, and a physical examination.
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During consultation with a surgeon, patients discuss the procedure, risks and benefits, and expected outcomes with a urologist or a kidney surgeon. In order to determine the most appropriate surgical approach, the surgeon evaluates the patient's condition.
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The risk of bleeding or other complications during and after surgery can be increased by adjusting or discontinuing certain medications or supplements. Informing the surgeon of any medications or supplements you are taking is important.
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Smoking Cessation: Patients who smoke are advised to quit several weeks before surgery, as smoking can impair wound healing and increase complications.
Procedure
Nephrectomy typically involves the following steps:
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General anesthesia or regional anesthesia with sedation may be used to ensure the patient's comfort and pain control during surgery.
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A surgeon makes an incision in the abdomen or the side of the back, depending on the type of nephrectomy being performed. The size and location of the incision may vary.
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The kidney is removed through an incision after the surgeon separates it from surrounding tissues, blood vessels, and the ureter (the tube that carries urine from the kidney to the bladder).
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Once the kidney has been removed, the incision will be closed with sutures or surgical staples. Drainage tubes may be placed near the surgical site to remove excess fluid and aid in healing.
Recovery
Patients usually experience the following recovery process after a nephrectomy:
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Following the surgery, patients may need to stay in the hospital for a few days to monitor their condition and manage pain. Healthcare providers monitor vital signs, administer medications, and provide instructions for postoperative care during this time.
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The healthcare team can prescribe pain medications to manage discomfort or pain at the surgical site.
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After surgery, patients should avoid strenuous activities, heavy lifting, and driving for several weeks to allow their bodies to heal properly. Gradual resumption of normal activities should be guided by their healthcare team.
Risks
Despite the fact that nephrectomy is generally safe, there are some risks and complications associated with the procedure, including:
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Excessive bleeding during or after surgery may require blood transfusions or additional interventions.
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Surgery wounds can become infected, which can delay healing and cause complications. Patients are advised to keep the surgical site clean and dry and follow wound care instructions.
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There is a risk of inadvertent injury to nearby organs, blood vessels, or nerves during the surgery, which may require further treatment.
Aftercare
The following aftercare recommendations should be followed after a nephrectomy:
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Patients are scheduled for follow-up appointments with their healthcare provider to monitor their recovery progress, assess kidney function, and address any complications that may arise.
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Exercise, a balanced diet, and avoiding tobacco use can promote optimal healing and reduce complications.
