OVERVIEW

When kidney tumors are small, are located in the periphery of the kidney, the patient has several tumors in both kidneys or when there is a risk that the patient has chronic renal failure after the total nephrectomy, it is better to perform a partial nephrectomy, in the which only removes the tumor or a part of the kidney in order to preserve renal function.

 

The reasons for performing a partial nephrectomy are:

  • Kidney cancer up to 4 cm (sometimes larger tumors can be removed)
  • Kidney cancer that is in the periphery of the kidney without invading other structures such as the renal vein
  • Kidney cancer in both kidneys
  • Patients at risk of having chronic renal failure after total nephrectomy

Benefits of laparoscopic partial nephrectomy

By removing only the tumor and leaving part of the kidney, you can preserve the kidney function and prevent the patient must receive a replacement treatment of renal function (peritoneal dialysis, hemodialysis or kidney transplant). The control of cancer with partial nephrectomy is excellent for tumors smaller than 4 cm, even comparable with radical nephrectomy, in the case of larger tumors or invasion of the renal vein, radical nephrectomy is preferred.

When performed by laparoscopy, partial nephrectomy is a surgery that offers rapid recovery and little postoperative pain.

Risks and complications

The possible complications that may arise when performing a partial nephrectomy are the same as those that can occur in general with any surgical procedure and these are: hemorrhage, damage to nearby organs, reactions to anesthesia, etc. However, these complications occur infrequently and can be resolved mostly during the same surgery.

The risk of conversion to open surgery is low, (<5%), this may be due to difficulty in dissection or hemorrhage and is done to maintain patient safety.

Despite retaining renal tissue, there is the possibility of requiring replacement treatment of renal function (peritoneal dialysis, hemodialysis, renal transplantation) temporarily or permanently, joint management with a nephrologist is suggested for this purpose.

Alternatives to partial nephrectomy

Other alternatives to control renal cancer are radical nephrectomy, cryoablation and radiofrequency ablation.

In patients with kidney cancer who are very weak and with small tumors (less than 4 cm), they can remain under surveillance.

What to expect from laparoscopic partial nephrectomy?

Day of surgery:

The day of the operation will arrive in the morning to the hospital in fasting.

The surgery lasts approximately 3 – 5 hours, however, this time is variable.

Anesthesia for this procedure is general, so you will be unconscious during surgery.

Pain after laparoscopic partial nephrectomy is minimal and can be effectively controlled with intravenous analgesics.

Food: on the day of surgery you can eat in the afternoon, there are no food restrictions, however, a balanced diet is recommended.

Physical activity: the day after surgery you can walk. It is expected to feel a bit fatigued after any surgery, this problem resolves spontaneously within a few weeks after laparoscopic partial nephrectomy.

Hospital stay: most patients who undergo partial laparoscopic nephrectomy remain hospitalized for 2 to 3 days.

Wounds: laparoscopic partial nephrectomy requires 3 small incisions in the abdomen (each 1 cm or less), the tumor is removed by one of these incisions, once they heal completely, these scars can rarely be seen.

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