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Nephrectomy

Surgery Overview

A nephrectomy (say "nih-FREK-tuh-mee") is surgery to take out part or all of the kidney. There are three kinds of nephrectomy:

  • Radical nephrectomy. The surgeon removes the entire kidney, the layer of fat around the kidney, the tube (ureter) that drains urine from the kidney to your bladder, the adrenal gland, and nearby lymph nodes.
  • Partial nephrectomy. The surgeon removes only the part of the kidney that is diseased, which allows the remaining part of the kidney to work normally. You may hear your doctor call this "nephron-sparing" surgery.
  • Simple nephrectomy. The surgeon removes only the kidney.

There are two ways to do the surgery:

  • Open surgery. The doctor will take out your kidney through a long cut (incision) in the front or side of your belly. The incision will leave a scar that will fade with time.
  • Laparoscopic surgery. The doctor will insert a thin, lighted tube (laparoscope) and surgical tools through several small cuts (incisions) in your belly. The doctor will remove your kidney through one of the incisions. The incisions will leave smaller scars than open surgery would. Some doctors may do robot-assisted surgery. The surgeon controls the robotic arms that hold the tools and scope.

You will be asleep during the surgery. The operation will take about 2 to 4 hours.

You will probably spend 3 to 5 days in the hospital.

What To Expect After Surgery

Your belly will feel sore. This usually lasts about 1 to 2 weeks. Your doctor will give you pain medicine for this. You may also have other symptoms such as nausea, diarrhea, constipation, gas, or a headache.

At first, you may have low energy and get tired quickly. It may take 3 to 6 months for your energy to fully return.

You will probably need to take 4 to 6 weeks off from work. It depends on the type of work you do and how you feel.

Why It Is Done

This surgery is usually done to treat kidney cancer.

Simple nephrectomy may be done to remove a kidney that is deformed or damaged and not working well. It's also done to harvest a healthy kidney for organ donation.

How Well It Works

For kidney cancer

Surgery works well for kidney cancer, especially when the cancer is found early.footnote 1

After kidney cancer has spread, the outlook is not as good, even with surgery.

The 5-year survival rate shows the average number of people still alive at least 5 years after surgery. It's important to remember that everyone's case is different. These numbers may not show what will happen in your case.

5-year survival rates after surgery footnote 2

For cancer that hasn't spread to the lymph nodes

For cancer that has only spread to the lymph nodes

For cancer that has spread to other organs

70 to 80 out of 100 patients are still alive 5 years after surgery.

15 to 25 out of 100 patients are still alive 5 years after surgery.

0 to 5 out of 100 patients are still alive 5 years after surgery.

Although surgery for patients whose cancer has spread to other organs may not help them live longer, it may improve symptoms.

For other kidney problems

When one kidney is removed, the other one expands to remove waste and fluids from the body. Most people do fine with only one kidney.

Risks

The risks are the same as for any major surgery. They include:

  • Severe bleeding.
  • Infection.
  • Risks linked with anesthesia.
  • An increased risk of getting a hernia where the cut was made for surgery.

What To Think About

If you have both kidneys removed, or if something happens to your remaining kidney, you will need to have wastes and fluids removed through dialysis or your kidney replaced through a kidney transplant.

This surgery is more difficult than many other surgeries, so having an experienced surgeon is important. So is having your surgery done at a hospital or medical centre where many of these surgeries are done. This can make a difference in how well your surgery goes.

References

Citations

  1. National Comprehensive Cancer Network (2012). Kidney cancer. NCCN Clinical Practice Guidelines in Oncology, version 1.2012. Available online: http://www.nccn.org/professionals/physician_gls/pdf/kidney.pdf.
  2. Cooper CS, et al. (2010). Urology. In GM Doherty, ed., Current Diagnosis and Treatment: Surgery, 13th ed., pp. 902–943. New York: McGraw Hill.

Credits

Current as of:
April 29, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Christopher G. Wood MD, FACS - Urology, Oncology
Douglas A. Stewart MD - Medical Oncology
Jimmy Ruiz MD - Hematology, Oncology