Radical Nephrectomy

What is Nephrectomy?

Nephrectomy is surgical removal of kidney, along with it's collecting system i.e. renal pelvis and ureter.

Where can I get Radical Nephrostomy?

Country	Cost with MedSolution
India	(Please inquire for price)

Cost of procedure performed in the US: $30,000.

All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.

What is Radical Nephrectomy?

Radical Nephrectomy is a surgical procedure in which the entire kidney with it's collecting system is removed along with the adrenal gland and lymph glands of the same side.

What are the different kinds of Nephrectomy procedures?

• Partial Nephrectomy or Hemi-Nephrectomy - In this procedure, a small part of one kidney is removed.
• Simple Nephrectomy - In this procedure all of one kidney is removed.
• Radical Nephrectomy - This procedure involves surgical removal of one kidney along with the neighbouring adrenal gland and lymph nodes on the same side.
• Bilateral Nephrectomy - This procedure entails surgical removal of both the kidneys.
• Unilateral Nephrectomy - In this procedure only one kidney is removed.

Who is an ideal candidate for Radical Nephrectomy?

If you have renal cell carcinoma (stage I, II or III) of kidney or polycystic kidney disease that has completely damaged your kidney tissue then you are an ideal candidate for Radical Nephrectomy.

How do I prepare for Radical Nephrectomy?

It is extremely crucial for your surgeon to assess your kidney function before Radical Nephrectomy. A thorough physical examination, ECG, chest x-ray, complete blood profile, complete kidney profile, pulmonary function tests, blood gas analysis, blood typing and cross matching is done in case transfusion is required during Radical Nephrectomy surgery. Specialized tests like intravenous pyelography, Cystoscopy / Ureteroscopy, retrograde pyelography, cystourethrography, CT scan, ultrasonography, MRI, renal angiography and renal venography will be performed for complete anatomic assessment. You will be hospitalized at least one day before the surgery. Inform your surgeon about your other health conditions and medications (including all the prescription, non-prescription medications, nutritional supplements i.e. vitamins, minerals and herbal products). Refrain from taking aspirin or Ibuprofen at least 2 weeks before Radical Nephrectomy. Stop smoking a few weeks before Radical Nephrectomy to prevent healing problems during recovery period. Do not eat or drink any thing for at least 10 - 12 hours before the Radical Nephrectomy surgery.

What does the procedure for Radical Nephrectomy involve?

Radical Nephrectomy is performed under general anesthesia. Radical Nephrectomy can be performed either by Open Abdominal approach or Laparoscopic approach. Abdominal approach can be anterior subcostal (incision runs on the front of the abdomen across the rib cage), thoracoabdominal, or flank (on the side) approach. The kidney is dissected free of it's attachments. The renal artery and vein are dissected and cut, ureter is cut and the adrenal gland is freed and removed along with the kidney. A drain will be left in and the wound will be closed. Laparoscopic Radical Nephrectomy is a minimally invasive procedure in which the kidney is removed by making four small incisions (each about 3 inches wide). Surgical instruments are used to free the kidney from it's surrounding structures and the kidney is removed through an incision in the front of the abdominal wall below the navel. The renal artery, renal vein and the ureter are then tied off and the incision is sutured. Radical Nephrectomy when using abdominal approach can take up to three hours. Laparoscopic Radical Nephrectomy can take a little longer.

What to expect during the recovery period following Radical Nephrectomy?

Following Radical Nephrectomy, you will spend the next few hours in the recovery room to monitor your heart and lung function and also to check for any immediate post operative complications like excessive bleeding. You will be hospitalized for about 5 - 7 days and those days can be quite painful and uncomfortable. You will be prescribed pain medication to cope with the pain. As with all other major surgeries, you will be encouraged to do deep breathing and coughing exercises following Radical Nephrectomy. Avoid strenuous activities, heavy lifting and playing sports for 2 - 3 weeks after Radical Nephrectomy. You will be able to return to your daily activities in 4 - 6 weeks. Your renal function would be monitored closely to make sure that one kidney can take over and compensate for the loss of the removed kidney.

What is the outcome of Radical Nephrectomy?

The outcome of Radical Nephrectomy depends on the size and type of the cancer. The survival rate for stage I Renal Cell Carcinoma (RCC) following Radical Nephrectomy is 93%. This is for the tumour that is confined to the kidney and has not spread to the outside tissues.

B . R . A . N . D . of Radical Nephrectomy

Benefits of Radical Nephrectomy

• After Radical Nephrectomy, the kidney on the opposite side compensates for the loss of one kidney and undergoes hypertrophy urine production is about 75 - 80% close to normal. You can lead a normal life with one kidney and have your kidney tumour removed by Radical Nephrectomy. With Laparoscopic Radical Nephrectomy, there is shorter hospital stay, less pain and quicker recovery.

Risks of Radical Nephrectomy

• Injury and perforation of internal organs like bowel, liver, spleen, pancreas and pleura
• Excessive bleeding and hemorrhage
• Failure of the opposite kidney
• Infection
• Other (rare) complications include heart attack, congestive heart failure, pulmonary embolism, cerebrovascular accident, pneumonia, and thrombophlebitis.

Alternatives to Radical Nephrectomy

• Cryosurgery - Renal Ablative Cryosurgery of localized renal cancer is a new technique that is gradually gaining popularity.
• Nephron Sparing Surgery - This is the alternative of choice when it is necessary to preserve the functioning renal parenchyma. This may be necessary in if you have renal cell carcinoma of both the kidneys, or renal cell carcinoma of the single kidney that is functioning, chronic renal failure, impairment of kidney function due to kidney stone, renal artery stenosis or diabetes.

Now or Never

• Radical Nephrectomy is the appropriate treatment for kidney cancer that is localized. Chances are that this would be the only treatment that you would require for your cancer. Your kidney function will be compensated for by the opposite kidney and you will be able to live a normal life.

Decision to have Radical Nephrectomy

• Radical Nephrectomy will not effect your bladder and you will not need a urostomy bag after the surgery. Radical Nephrectomy could be worthwhile having as the symptoms of kidney cancer like pain, blood in the urine, fever or weakness can be relieved by removing the tumour. Removing the kidney tumour by Radical Nephrectomy can help you alleviate your symptoms.