Rehabilitation after kidney resection, possible complications after surgery
Resection of the kidney is an operation that involves the removal of part of the kidney. It is performed in the presence of tumors, injuries, tuberculosis, polycystic kidney. The operation is organized by an open method or by means of a laparoscope through small incisions. Any resection is performed under general anesthesia and is completed by insertion into the area of the drainage tube resection. Drainage is recovered a few days after the liquid ceases to separate from the wound. Rehabilitation after a kidney resection is to conduct a correct restoration of her work.
Indications and contraindications for operation
This operation is organized in case of incomplete organ damage, but only part of it. This happens with the development of kidney tuberculosis, closed wounds, open wounds, the presence of a tumor neoplasm.
The main indications of a kidney resection are:
- The tumor size is up to 4 cm, provided that the second kidney is preserved.
- High risks of diagnosis of kidney cancer.
- Rapid progression of a tumor of a benign character or with a suspicion of its malignancy.
- Bilateral oncology of the kidney.
- High risks of chronic renal failure.
- Urolithiasis when the stone is in the lower dilated calyx.
- Defeat of the kidney segment due to trauma.
- Segmental form of hydronephrosis.
Kidney resection should not be performed in the case of a patient's condition or with accompanying pathologies, when the risk of getting complications during the operation increases.
Preparing for operation
An anesthesiologist is required to inspect the patient before performing the operation.
Preliminary examination consists in organization of general examination, laboratory tests and instrumental examination:
- Ultrasound examination, computed tomography and MRI.
- Radiographic examination with contrast agent management.
- Renal angiography.
- Renal perfusion, etc.
Before the operation, the patient needs to be hospitalized for two to four weeks, and before entering the hospital, the following tests are performed:
- blood tests for syphilis;
- blood test for HIV;
- blood tests for hepatitis;
- radiograph of the chest.
In the patient's hospital, the therapist and anesthesiologist examines the doctor, in the evening before the operation, the cleansing enema is staged.
Carrying out operation
The operation on the kidney resection is performed under general anesthesia.
The patient lies on a healthy side, under which a special roller is placed. To further fix the position, the operating table devices are used.
In the area of the waist, the surgeon makes an incision of an arcuate shape measuring 10 to 12 cm, then a layer cut is made to access the kidney. The renal leg is clamped by means of an elastic clamp to reduce bleeding during excision of the tissue.then the excision of the affected area of the kidney is performed. A drainage tube is brought to the site of the resection in order to control the kidney to be separated after resection. Then the wound is sutured.
Complications of operation
Continuous discharge by drainage indicates the development of obstruction of the urinary canals. Fistulas are rarely formed, usually with a large tumor or after reconstruction of the renal-pelvic system. Fistulas can appear after a sphenoid resection of the kidney, provided that the defect is sutured by the mattress sutures. Urinoma may be manifested due to insufficient drainage of the kidney.
Often after performing kidney stones removal operations with additional infection of the urinary tract, a wound infection develops.
A rare complication is the formation of thrombi in the artery of the kidney due to damage to its intima.
After completing a kidney resection, 3% of patients need a nephrectomy. Acute kidney failure can form after resection of a single kidney due to the presence of a large tumor, the removal of a large amount of kidney tissue or because of prolonged ischemia of the kidney parenchyma. After the resection for the child, kidney function may gradually worsen due to excess perfusion of the remaining kidney parenchyma.
The resection of the kidney postoperative period in the first day a person spends in the intensive care unit, and then he is transferred to the department.
Often after completion of surgery, patients complain of pain in the wound area, for the elimination of which the administration of pain medication is prescribed.
The frequent urge to urinate after surgery is associated with the presence of a catheter in the bladder, as his cannula irritates the neck of the bladder, provoking false desires. You can take food the next day, and after the normalization of the chair it is allowed to return to the usual diet. If there is no stool on the third day after the operation, a cleansing enema is put.
On the second day after surgery, it is allowed to organize moderate motor activity, for example, walking along the corridor of the hospital.
Drainage is removed after three to five days. On the seventh - the twelfth day, the sutures are removed, and until this moment the doctor constantly makes dressings.
Catheter is excreted from the bladder for a maximum of the third day.
After discharge from the hospital, the person must observe the following rules:
- Avoid large physical exertion.
- Wear a bandage for one month.
- Four weeks after the operation, it is allowed to return to normal life and work.
After resection of the kidney, mandatory checkups should be performed once every three months. The final recovery is achieved one year after the operation.
To ensure that recovery after resection of the kidney has passed properly, it is necessary to follow the doctor's recommendations for the prevention of complications. For this, the patient must perform breathing exercises, begin to gradually get up and walk a few days after the operation. Such actions help restore normal functioning of the intestine and prevent the formation of thromboembolic complications.
For the first time after surgery, the patient may feel tired and it may take up to eight weeks to fully recover well-being.
operation As a rule, after an open resection less complications are formed than nephrectomy, because this operation involves less aggression and tissue trauma. But after it complications can develop, such as:
- Blood circulation disorders in the brain.
- Inflammation of the lungs is stagnant. Acute myocardial infarction.