Partial Nephrectomy

A kidney tumour is often surgically removed along with a thin rim of normal kidney. This is called partial nephrectomy that is done with the two aims of curing cancer and preserving as much normal kidney as possible.

History

In the year 1890, the world first heard of partial nephrectomy. However, it was not practised much at that time because of limited x-ray and imaging capabilities to find small kidney tumours. The early operations also had significant complications associated with them. In the present days, partial nephrectomy is done quite often as there are the advantages of improved imaging, improved surgical techniques and increased kidney tumour detection.

Indications

There are different cases in which a partial nephrectomy is attempted by a nephrologist in Kolkata. Some of them are when there is a kidney tumour in a solitary kidney, when there are kidney tumours in both kidneys, or when removing the entire kidney could result in kidney failure and the need for dialysis. Many patients are found to have small renal masses (<4 cm in size). The standard treatment option in almost all these cases is partial nephrectomy. This method is also used when renal masses between 4-7 centimetres are located in the proper position.

Procedure

A patient is put under general anaesthesia when partial nephrectomy is performed. An open, laparoscopic or robotic approach is undertaken to perform a partial nephrectomy. While placing the patient on the operation bed, he or she is laid on the side opposite the kidney tumour. In order to remove the kidney tumour along with a thin rim of normal kidney tissue, this procedure is done. The flow of all blood is ultimately through the kidneys as they clean the blood. With each heartbeat, 25% of the blood will go into the kidneys. A nephrologist often temporarily blocks the blood flow to the kidney for safely removing the kidney tumour. The remaining kidney is sewn back together after the tumour is cut off.

Cancer control, quality of life, and survival

In a recent meta-analysis, it was confirmed that the chance of cure in from the renal cell cancer in partial nephrectomy is the same as that in a radical nephrectomy. In comparison to total removal, kidney function is found to be better maintained in partial nephrectomy. It has been found in some studies that compared to the patients who had their whole kidney removed, those who were treated by partial nephrectomy live longer.