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Radical Nephrectomy Procedure in India

Radical nephrectomy involves the removal of the entire kidney along with surrounding fatty tissue and occasionally the adrenal gland and lymph nodes. Get expert medical advice with Pristyn Care by discussing radical nephrectomy with an expert urologist and understand the best line of action for your treatment. Book an appointment today with our experienced doctors to know more about your treatment options.

Radical nephrectomy involves the removal of the entire kidney along with surrounding fatty ... Read More

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    Dr. Ankit Kumar (Id6NCCAzQu)

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  • What is Radical Nephrectomy?

    Radical nephrectomy is a surgical procedure that is typically performed to treat kidney cancer, other kidney diseases or injuries, or when a kidney is being donated for transplantation. During this radical nephrectomy procedure, not only is the affected kidney removed but also the surrounding fatty tissue. In some cases, the adrenal gland and lymph nodes may also be removed.

    The radical nephrectomy procedure is carried out by a skilled surgeon in an operation theatre (OT) and depending on the type of nephrectomy, may involve a single large incision (open radical nephrectomy) or several small incisions (laparoscopic radical nephrectomy). Both methods are effective yet their application depends on the patient’s condition and the size of their tumour. Despite being a major surgery, radical nephrectomies are commonly performed with successful results.

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    What Are The Types Of Radical Nephrectomy?

     

    Radical nephrectomy can be categorised into two primary types based on the surgical approach:

    • Open Radical Nephrectomy: This traditional method involves a single large incision in the abdominal wall to access and remove the kidney. In this process, the surgeon separates the renal artery, renal vein, and ureter from the kidney before its removal. This radical nephrectomy technique is often employed for larger tumours or complicated cases where thorough lymph node clearance is required.
    • Laparoscopic Radical Nephrectomy: This is a minimally invasive surgical procedure carried out through several small incisions in the abdomen. The surgeon uses a laparoscope, equipped with a tiny camera on the end, to visualise the surgical site. This method has grown more prevalent than open surgery due to its association with faster recovery times.

    It is essential to learn about radical nephrectomy meaning and discuss with your doctor to prepare for post-surgical recovery and potential outcomes.

    Diagnosis Before Kidney Removal Surgery

    To make a precise diagnosis and determine whether a radical nephrectomy is required, your doctor will employ various diagnostic techniques. Here are some essential tests your urologist might recommend:

    • Imaging Tests: These include CT scans, MRIs, or ultrasounds. They are often the first step in diagnosing kidney cancer and can also detect if the cancer has spread to other parts of your body.
    • Staging Evaluation: This process is crucial to understand the extent of the cancer. It involves imaging of the chest, abdomen, and pelvis, as well as comprehensive blood work.
    • Analysis of Growth: If a suspicious growth is found on the kidney, it is analysed to determine if it is solid and enhances or picks up contrast dye. If so, it’s likely to be cancerous.

    Symptomatic Diagnosis: For advanced cases where the tumour has spread beyond the kidney, diagnosis often follows the emergence of symptoms like abdominal/back pain, blood in urine, bone pain or neurological symptoms.

    What Is The Procedure For Radical Nephrectomy?

    Radical nephrectomy involves removing the entire kidney and sometimes additional structures, depending on how far the cancer has spread. Here’s what happens during the radical nephrectomy procedure:

    • General Anaesthesia: To begin with, you will be placed under general anaesthesia to ensure a pain-free operation.
    • Size Determination: The surgeon will first ascertain the size of your tumour, which helps decide on the next best steps.
    • Separation: The renal artery, vein, and ureter are carefully separated from the kidney prior to removal.
    • Surgical Technique: Depending on various factors like tumour size and location, either an open incision or a minimally invasive laparoscopic approach can be used.
    • Lymphadenectomy & Adrenalectomy: If enlarged lymph nodes are detected, they may also be removed in a procedure called lymphadenectomy. If the cancer has spread to the adrenal gland, it might be removed as well.
    • Recovery Monitoring: After the kidney removal, you will be monitored for any complications like infection, bleeding, and changes in kidney function.

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    Who Is The Right Candidate For Radical Nephrectomy?

    Determining the right candidate for a radical nephrectomy depends on several factors. The radical nephrectomy procedure is typically recommended in the following cases:

    • Localised Kidney Cancer: Radical nephrectomy is considered the standard treatment for kidney cancer that hasn’t spread to other organs.
    • Large Tumours: If the tumour is large and extends into major blood vessels or involves nearby organs, then this surgery could be an option.
    • Acceptable Kidney Function: For undergoing a radical nephrectomy, the other kidney in the patient’s body must be functioning properly to take over the functions of the removed kidney.

    Overall Health Status: Your overall health status and ability to undergo a major surgical procedure also play a significant role in determining if you’re a suitable candidate for radical nephrectomy.

    What Are The Benefits Of Radical Nephrectomy?

    Understanding the benefits of a radical nephrectomy could help you make an informed decision about your kidney cancer treatment. Here are some key benefits:

    • Complete Tumor Removal – Eliminates localized kidney tumors, potentially curing the cancer.
    • Prolonged Survival – Significantly increases survival rates for patients with kidney cancer.
    • Symptom Relief – Alleviates symptoms like pain, bleeding, or obstruction caused by the tumor.
    • Prevention of Metastasis – Reduces the risk of cancer spreading to other parts of the body.

    Improved Quality of Life – Enhances overall well-being by removing the source of cancer-related complications.

    How To Prepare For Radical Nephrectomy?

    Preparing for a radical nephrectomy procedure is a crucial step towards a successful outcome. Here’s what you need to do:

    • Undergo Blood Tests: The doctor will order blood tests to determine blood type in case a transfusion is needed during or after the surgery.
    • Medication Management: It’s important to stop taking certain medications like blood thinners as instructed by the doctor.
    • Quit smoking: Smoking can interfere with healing and complicate surgery, so quitting is strongly recommended to promote faster healing and reduce complications post-surgery.
    • Fasting: You should stop eating or drinking after midnight the night before the radical nephrectomy procedure.

    What Are The Recovery Tips and Precautions To Follow After Radical Nephrectomy?

    Post-surgery care after radical nephrectomy can be challenging, but with careful monitoring and adherence to guidelines, you can expedite your recovery. Here are some tips:

    • Expect a Hospital Stay: Depending on the surgical approach used, your hospital stay could range between 1 to 7 days.
    • Be Vigilant About Symptoms: Monitor your condition for fever, heavy bleeding, or severe pain and report to your doctor immediately.
    • Gradual Physical Activity: Increase your physical activity slowly to promote healing and reduce complications like pneumonia.
    • Avoid Certain Activities: Avoid contact sports to protect the remaining kidney.

    Regular Check-ups: Regular follow-ups with your doctor are crucial for recovery and health management.

    Potential Risks Or Complications Associated With Radical Nephrectomy

    Like any surgical procedure, a radical nephrectomy carries its own set of risks and potential complications. Here are some you should be aware of:

    • Infection: This is always a risk after surgery and could lead to complications if not treated immediately.
    • Bleeding: Post-operative bleeding could occur which needs immediate medical attention.
    • Pneumonia: Post-operative pneumonia is a risk associated with many types of surgeries.
    • Allergic Reaction: Though infrequent, an allergic reaction to anesthesia could pose a serious risk.
    • Reduced Kidney Function: The remaining kidney might undergo reduced function, increasing the risk of chronic kidney disease and cardiovascular disease.

    Despite these potential complications, radical nephrectomy remains an effective treatment for localised kidney cancer, with laparoscopic approaches offering faster recovery times. Careful preparation and follow-up are crucial to manage potential complications and optimise outcomes.

    What Is The Cost Of Radical Nephrectomy In India?

    The typical cost of a radical nephrectomy in India ranges from ______ to —. However, just like any other surgical procedure, the cost can vary based on several factors including:
    Hospital: Different hospitals have varying price structures. The hospital’s facilities, reputation, and location can significantly influence the cost. Metropolitan cities may have a higher cost due to more expensive hospital setups than smaller towns.
    Surgeon’s Expertise: A highly skilled and experienced surgeon may charge more for performing a left radical nephrectomy or right radical nephrectomy compared to a less experienced one.
    Patient’s Medical Condition: The health condition of the patient can also impact the total cost. For instance, if the patient has other medical complications, the total cost might increase due to additional medications or treatments needed.

    Is Radical Nephrectomy Covered Under Insurance?

    In India, radical nephrectomy may be included under some health insurance plans. These insurance policies can provide relief from the burden of expense, but the degree of coverage varies. Some policies might cover the full cost of the radical nephrectomy procedure, while others might only offer partial coverage with co-payments or deductibles.

    It is essential to scrutinise your insurance policy’s specific inclusions and exclusions relating to radical nephrectomy – this ensures you understand what costs will be covered.

    Moreover, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), India’s flagship health insurance scheme, includes coverage for radical nephrectomy. This scheme aims to provide financial protections by covering secondary and tertiary hospitalisation costs (which include procedures like left radical nephrectomy or right radical nephrectomy) up to Rs.5 lakhs per family per year.

    To summarise, whether you’re undergoing a left radical nephrectomy or a right radical nephrectomy procedure, it’s crucial to understand your insurance plan’s terms and conditions to avoid any unforeseen expenses. Taking time to do this will help ensure that your focus remains on recovery, not financial stress.

    FAQ Around Radical Nephrectomy

    How does the right radical nephrectomy differ from the left radical nephrectomy?

    Essentially, the difference between a right radical nephrectomy and a left radical nephrectomy lies in the specific kidney being removed. In a right radical nephrectomy, your doctor will remove your right kidney, while in a left radical nephrectomy, your left kidney is the one being removed.

    Can I live with only one kidney after a left radical nephrectomy?

    Yes, you can certainly live a normal life with just one healthy kidney. After a left radical nephrectomy, your remaining right kidney will continue to perform its functions. It can even grow slightly to compensate for the loss of the removed kidney.

    How does a radical nephrectomy procedure impact my lifestyle?

    While recovery from a radical nephrectomy procedure might require some minor lifestyle changes initially, most individuals can return to their normal activities once they have healed. Regular health check-ups are crucial to ensure that your remaining kidney is functioning properly. Also, maintaining a balanced diet and staying well-hydrated is essential.

    How long does radical nephrectomy procedure usually take?

    Typically, a radical nephrectomy procedure can take anywhere between two to four hours to complete, depending on the complexity of the case and the patient’s overall health condition.

    Are there any alternatives to a radical nephrectomy available?

    Yes, alternatives like partial nephrectomy where only the diseased part of the kidney is removed exist and are considered in cases where the patient’s overall health could be compromised by removing an entire kidney.

    Will I require dialysis after undergoing a radical nephrectomy?

    Most people do not require dialysis after a radical nephrectomy as long as their remaining kidney is healthy and functions well. However, your doctor will monitor your kidney function closely after the surgery to ensure no complications arise.

    How long will I have to stay in the hospital after a radical nephrectomy?

    The length of the hospital stay after a radical nephrectomy varies based on factors like your overall health, the type of surgery performed, and how quickly you heal. On average, you might need to stay in the hospital for a few days following the surgery.

    Are there any dietary restrictions following a radical nephrectomy?

    Following a radical nephrectomy, it’s generally recommended to eat a balanced diet with adequate amounts of protein. Reducing sodium intake and staying well-hydrated can also help support your remaining kidney function.

    Can I exercise after having a radical nephrectomy?

    Yes, physical activity is encouraged once you’ve healed from the operation. However, heavy lifting or strenuous activities should be avoided until your doctor advises otherwise.

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    Content Reviewed By
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    Dr. Ankit Kumar
    16 Years Experience Overall
    Last Updated : September 20, 2024