- Nephrectomy is a procedure of the surgical removal of kidneys
- Nephrectomy is required by people whose kidneys are non-functional
- Kidney cancer is one of the most common forms of cancer in the world
Nephrectomy is a procedure of the surgical removal of kidneys. While it is mainly performed in cases when three-fourth of the kidney is occupied by tumour or when it is dysfunctional; a recent study revealed something different. It said that a robotic partial nephrectomy can help reduce complications and improve mortality rates in patients as compared to laparoscopic techniques. For patients dealing with early kidney cancer, partial removal of the kidney is better than complete removal to preserve normal kidney function. The study also showed that robotic partial nephrectomy has better outcomes to offer for patients with reduced risk of complications and reoccurrence of cancer. Results also showed that this technique was equivalent or better than laparoscopic techniques. Kidney cancer is one of the top 10 most common forms of cancer in the world.
For a better understanding of what nephrectomy is all about, we spoke to urologist Dr Pradeep Bansal. He said, "Nephrectomy is the surgical removal of only one kidney. Removal of both kidneys takes place in deceased patients who donate their organs. It is also done in patients who have an infected or tumour bearing kidney. Right before the transplant surgery, both kidneys are removed from the body. However, in most cases, both kidneys are never removed from the patient's body. Doing this can result in urine, blood-related and calcium metabolism-related problems in the body."
What are the types of nephrectomy?
Dr Bansal revealed that nephrectomy, broadly, is of two types; donor and diseased. "Donor nephrectomy is one in which a person is donating a kidney for the purpose of transplant. In this case, the donor can only be the blood relative or the spouse. These donor kidneys are mobilized in a laparoscopic technique. In this a bigger incision is not given on the upper part of the abdomen because the kidneys are located in the upper back side of the abdomen. With an incision of less than a centimeter, the kidney is mobilized and then it is removed from the lower abdominal incision. So the problems which arise from large incisions in the body are not experienced by patients any longer. Diseased kidney like an infection-bearing, cancerous or non-functional kidney can also be removed in the same way," he explained.
When does a patient need nephrectomy?
Dr Bansal explains the three different types of conditions wherein a patient needs to go through a nephrectomy. He says, "Nephrectomy is required by people dealing with kidney failure. The fact that the kidney is dysfunctional is confirmed through a CT scan or a kidney function scan. If the kidney function is less than 10% and it is not contributing to anything in the body, then the kidney is termed non-functional. Such kidneys can be removed as they can cause high blood pressure and infections in the body. Another case where a nephrectomy is required is when the kidney is affected by an infection which cannot be controlled with the help of medication."
"In case of kidney cancer, the patient may need to go through this procedure. When the tumour occupies more than three-fourth of the kidney, in this case radical nephrectomy is performed. Radical nephrectomy is a procedure in which the kidney and its surrounding tissues are also removed from the body," he added.
To conclude, Dr Bansal said, "The human body has two kidneys; if one stops functioning, the other one is there to support. Millions of people are born with just one kidney and they still continue to lead a normal life. If a patient needs a nephrectomy no matter what, like in case of kidney cancer or non-functional kidney, this procedure proves to be life-saving for the patient. Otherwise, those who donate a kidney, even they lead a normal life. However, these people need to keep a tab on blood pressure and blood sugar. These conditions are the biggest contributing factors responsible for renal failure. There is no restriction on diet and activities a person can engage in after going through a nephrectomy."
(Dr Pradeep Bansal is the Director and Head of Unit, Urology and Renal Transplant at Fortis Memorial Research Institute, Gurgaon)
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