Nephrectomy of the kidney: indications and contraindications for surgery

Nephrectomy is a surgical procedure to remove part of the kidney or the entire kidney. Such an operation is performed under general anesthesia.

Indications for nephrectomy

Nephrectomy is recommended for the following diseases of this organ:

• urolithiasis with purulent complications and large stones;
• is a tumor larger than 7 cm;
• injury;
• kidney failure;
• gunshot wound;
• non-functioning kidney;
• polycystic;
• developmental anomaly;
• is a serious infection.

Nephrectomy is also used to remove a healthy kidney from the donor for transplantation.

Contraindications

Nephrectomy is contraindicated in:

• bleeding disorder;
• lesion of the second kidney;
• is the only one;
• cardiac decompensation;
• taking medications that dilute blood;
• Decompensation of diabetes mellitus.

How the nephrectomy is performed

Partial nephrectomy removes only part of the kidney that is infected or affected by the disease. With radical nephrectomy, the entire kidney, parts of the adrenal gland, ureter and adipose tissue that surrounds it are removed. The related donors perform a simple nephrectomy for organ transplantation, while the kidney is removed with a part of the ureter.

Open

Open nephrectomy is performed by making an incision in the anterior or lateral abdomen. The blood vessels that connect the kidney to the body cross and bandage, then the ureter is crossed and bandaged between the kidney and the bladder. In connection with the type of nephrectomy, the ureter, adrenal gland and surrounding tissue can be removed. After removal of the organ, the vessels and ureter are bandaged and the skin incision is sutured.

Laparoscopic

Laparoscopic nephrectomy is a method of minimally invasive surgery. In this operation, laparoscopic instruments are used, with which you can see and cut the kidney. The doctor receives the image of the kidney with a flexible laparoscope. Surgical instruments and a laparoscope are inserted through four small incisions into the abdominal cavity.

When the kidney is cut, it is placed in a special bag and taken out of the abdominal cavity through the fifth incision just below the navel with a length of about 7.6 centimeters. Such a nephrectomy is much longer than an open nephrectomy, but studies have shown that the hospital stay after laparoscopic nephrectomy is less, and postoperative pain syndrome is reduced, and recovery processes are accelerated.

Postoperative period

If pain occurs in the area of ​​the incision during the postoperative period, the patient is prescribed injections of pain medications. A couple of hours after the operation, the patient can rinse the mouth and, if there is no nausea and vomiting, take a few sips of water, while drinking should be in small portions. Eating at a favorable current resumes to the next day. It is allowed to eat meat broth, dietary boiled meat, fat-free yogurt and cottage cheese.

After an independent chair, the food ration can be expanded. If there is no stool for three days, the patient is given enemas. In the diet of a patient who has undergone radical nephrectomy, there should be no smoked, fried, salted, liquid should drink at least 2500 ml.

You can go to the ward after surgery to the patient the next day, and after a day walk along the corridor is permitted. At the first ascent from a bed, patients often experience dizziness, darkening in the eyes, flashing of flies. The patient is made regular bandaging, by 9-10 days remove the stitches, in addition, prescribed antibacterial therapy for 15 days.

Postoperative complications of

Consequences after surgery depend on concomitant diseases of the patient, preoperative preparation and experience of specialists. In the postoperative period, mainly nonspecific complications occur, which are caused by a long stay in motion and general anesthesia.

These include:

1. pulmonary embolism;
2. congestive pneumonia;
3. thrombophlebitis;
4. stroke;
5. myocardial infarction.

However, such complications are rare.