When nephrectomy and possible consequences of kidney removal are required
Nephrectomy is a kidney operation involving removal. Such an operation is organized only under general anesthesia, and the consequences of kidney removal depend on the professionalism of the doctor and on the patient's state of health.
Kidney pathologies in which nephrectomy is necessary may be as follows: oncological lesions, polycystosis, when the cyst begins to replace the kidney tissue, and serious infectious diseases. Nephrectomy is also used to remove a healthy kidney from a donor for subsequent transplantation.
Nephrectomy involves removal of the entire kidney with nearby tissues or only part of it. When performing a partial nephrectomy, only the infected part or the affected part of the organ is removed. Complete nephrectomy consists in carrying out a complete removal of the kidney, partly the ureter, the adrenal gland and surrounding the kidney of adipose tissue.
Surgical access
Nephrectomy can be performed through several approaches. The most common method of organizing an operation in urological practice is lumbar extraperitoneal access in the 10th to 12th hypochondrium. In the development of oncology, doctors prefer transperitoneal access, and the most commonly used approach is median laparotomy.
Its advantages include the patient's available position on the operating table, mild trauma, speed of operation, etc. In addition, the median laparotomy allows for rapid treatment of the kidney vessels without additional manipulation during the development of the tumor process.
If the tumor in the kidney is large, the most convenient method of accession is a one-sided or two-sided subcostal.
The basic rule for implementing any access is to go as quickly as possible to the vascular pedicle.
Consequences of surgical intervention
During the recovery period after nephrectomy, the patient receives a strong pain medication. Serious consequences of the operation to remove the kidney can be prevented if all the doctor's recommendations are observed.
You can take food the very next day after surgery, in addition, there are no special restrictions on the consumption of products for the patient.
Already on the second - third day after nephrectomy, you can start to move a little, namely walk along the corridor of the hospital.
The drains established during the operation are removed on the fifth day, and the seams are removed on the eighth - twelfth day after the operation. Then, during one month, you need to limit physical activities and be sure to wear a bandage. Subsequently, people gradually return to the habitual for him life.
The mandatory rule of life for a person with a single kidney is careful adherence to preventive measures to prevent infection of the reproductive system. To do this, it is necessary to prevent hypothermia, to try to avoid promiscuity and to visit the doctor on time, even with minimal suspicion of the development of inflammation in the body - especially the peritoneum organs and pelvic organs.
The results of the operation
The results of the removal of the kidney completely depend on the goals that pursue the nephrectomy, as well as the type of surgical intervention being performed. Immediately after surgery, pain may occur after removing the kidney in the area of the surgical suture, especially during deep breaths or when coughing.
The specialist should carefully monitor the work of the kidney remaining in the person. If it is completely healthy, it begins to function more actively to compensate for the absence of the second kidney.
The length of the hospitalization period depends entirely on the complexity of the operation performed. A patient after laparoscopic nephrectomy is discharged after two to five days. After the usual open surgery to remove the kidney patient must stay in the hospital for at least one week. The timing of recovery also depends on the individual characteristics of the human body and on average varies from three to six weeks.
Complications after surgery
Complications after kidney removal are formed in only 2% of patients. Nonspecific manifestations of complications are the development of acute myocardial infarction, heart failure, impaired blood flow in the brain, thromboembolism, pneumonia, and the like. The frequency of complications can be reduced by observing special settings during the preparation for the operation, in the implementation of prophylaxis of hypotension in the course of the operation, while performing the correct infusion therapy.
When answering the question of what consequences after removal of the kidney are the least likely, mention should be made of the formation of the fistula of the pancreas, if it has been damaged during the operation.
Often in the postoperative period, patients may develop symptoms of pancreatitis, and also the secretion of juice from the pancreas. In this case, the discharge goes through a special drainage and should be examined for the presence of pancreatic amylase. If the drainage is not properly organized, fluid accumulation may occur behind the peritoneum, and pseudocysts or abscesses will begin to form. With proper drainage, almost all fistulas can close themselves.
Paresis in the intestine, developed after nephrectomy, usually passes on its own after three - four days. The consumption of fluid can begin after the recovery of peristalsis and the escape of gases. Occasionally, the probe may be required. The temperature after removal of the kidney is a sign of the development of the inflammatory process.
With the development of secondary bleeding from the operating wound, it can be supplemented by signs of hemorrhagic shock, pain, palpable bloating and drainage of blood. The source of such a process is the vessels of the adrenal gland, the kidney legs or the liver or spleen damaged during surgery. In most cases, relaparotomy is necessary to eliminate bleeding.
Consequences after kidney removal may result in the development of renal failure. Especially after nephrectomy, performed to eliminate a tumor clot, which involves clamping the contralateral veins of the kidney.
Usually, the functioning of the remaining kidney is gradually restored, but occasionally it may be necessary to transfer the patient to temporary hemodialysis.
Preventive measures after operation
After organizing traditional nephrectomy, it is forbidden to exercise and exercise any physical activity for the next three to four months. After the implementation of laparoscopic nephrectomy, the recovery period is markedly reduced. Regardless of this, it is necessary to prevent hypothermia, to refrain from consuming alcoholic beverages, and it is also recommended to walk more in the fresh air.
Any surgical intervention does not exclude the appearance of complications that can make themselves felt, both during the operation and after its completion. Often the causes of complications are the individual characteristics of the body.
After removal of the kidney, the patient should be sent to the urologist on a regular basis, who will perform a qualitative assessment of the remaining kidney function and will constantly monitor possible repeated lesions.