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Doctor insights on: Pathophysiology For Radical Nephrectomy

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Dr. Richard Link
1,056 Doctors shared insights

Nephrectomy (Definition)

Surgical removal of kidney for ...Read more


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What are the risk for having a radical nephrectomy?

What are the risk for having a radical nephrectomy?

MANY: The risk of any major surgery: bleeding, infection, scar, anesthesia risks, death. ...Read more

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What does it mean tohave an open radical nephrectomy?

Nephrectomy: " open" means a procedure performed through a relative large incision. Radical means they will remove not only the target organ ie kidney but also some surrounding tissue such as the fatty tissue surrounding the kidney along w lymph nodes. Radical surgery is recommended when there is a cancer concern. ...Read more

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What are some complications to look out for after a laparo radical nephrectomy? Risk factors?

Lap nephrectomy: Contrary to popular belief, laparoscopic organ removal has about the same complication risk as open surgery. Internal bleeding, infection, pneumonia, blood clots and incisional hernias can occur in both surgeries. Most young/healthy patients do well after either surgical approach. ...Read more

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Anything to know post-radical nephrectomy? Is there anything life threatening? When should one wait on the kidney transplant list?

Anything to know post-radical nephrectomy? Is there anything life threatening? When should one wait on the kidney transplant list?

Depends: If your remaining kidney is normal your likelihood of needing dialysis or a transplant is very low. In fact if you are born with 1 kidney your risk is the same as people born with 2 kidneys. Follow up of kidney transplant donors demonstrates a very small increase in risk. I would recommend a low sodium diet, avoid tobacco, avoid obesity and maintain a normal bp. Have labs checked yearly. ...Read more

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My father had a radical nephrectomy 3 years back. He lost one kidney. Recently tests shown his creatinine level 2.0. Not diabetic. How to lower down?

My father had a radical nephrectomy 3 years back. He lost one kidney. Recently tests shown his creatinine level 2.0. Not diabetic. How to lower down?

Follow-up: If dad is a well-muscled man (which raises creatinine well above "normal range" for today's couch potatoes) and we already know why he lost half his nephrons, this may not be an issue. I trust he is being followed up and that folks are watching for focal-segmental glomerulosclerosis / hyperfiltration lesion that's fairly common in kidneys that lose their partner. Don't try to treat a lab value. ...Read more

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Foot drop after radical nephrectomy surgery?

Foot drop after radical nephrectomy surgery?

Peroneal nerve: Isolated foot drop after surgery is likely due to pressure on the lateral aspect of the leg just below the knee during surgery. As seen in the picture, the peroneal nerve is at risk of pressure injury where it crosses the fibula. This kind of "palsy" due to pressure may recover spontaneously over weeks to months. If not, orthotics or surgery to graft a nerve along the injured area may help. ...Read more

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What are the risk for a chronic obstructive pulmonary disease (copd) patient having a radical nephrectomy?

What are the risk for a chronic obstructive pulmonary disease (copd) patient having a radical nephrectomy?

Depends: COPD exists with varying severity, and most patients can have surgery with no significant increased risk. If COPD is very severe, or there is significant chronic sputum production, surgical risk is higher, but experienced teams of surgeons, anesthesiologists, nurses, and respiratory therapists can help mitigate the risk. One important thing you have control over is pre-op smoking cessation. ...Read more

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Right radical nephrectomy in June 2013 and a partial nephrectomy July 14 this year. I have urgency, but little urine flow. UTI or kidney adjusting?

Right radical nephrectomy in June 2013 and a partial nephrectomy July 14 this year. I have urgency, but little urine flow. UTI or kidney adjusting?

Kidney adjusting: After nephrectomy it is essential the remaining kidney be able to filter the large amt. Of serum for remove of toxins and have the tubules reabsorb 90% of the filtered serum otherwise dehydration would occur. Following partial nephrectomy decreased renal tubules respondig to antidiuretic hormone are diminished and will have to adjust to the more tubular filtering and ADH (vasopressin) readsoption ...Read more

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Day before laparo radical nephrectomy, mom told to take magnesium citrate. What for, and is it supposed to be liquid or pill?

Day before laparo radical nephrectomy, mom told to take magnesium citrate. What for, and is it supposed to be liquid or pill?

Bowel prep.: Magnesium citrate, which is a liquid that comes usually in a green bottle at the drug store, is often used before laparoscopic surgery to prep the bowel. It is a laxative, and cleans out the intestines of stool. This is usually done the day before surgery, and we recommend starting it early so that the patient is not up all night on the toilet. ...Read more

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What"s the prognosis of stage 1 and fuhrman grade-2 clear cell renal cancer in 60 yr asymptomatic diabetic male after 2 yrs of radical nephrectomy?

What"s the prognosis of stage 1 and fuhrman grade-2 clear cell renal cancer in 60 yr asymptomatic diabetic male after 2 yrs of radical nephrectomy?

About 90% survival: Depending on the series, you will find estimates from 67% to 94%. With stage I disease, the grade is less important in determining prognosis. A two year disease free interval improves the outlook over the stage alone. ...Read more

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My father had Open radical nephrectomy 3 weeks ago and now he complains of abdominal pain and distention. It's normal??

My father had Open radical nephrectomy 3 weeks ago and now he complains of abdominal pain and distention. It's normal??

No: By using the word "now" you imply that he was not having (much) recovery pain but now has developed some along with distention. This is urgent. Call his doctor immediately and see whether they want him to come in NOW or meet at the ER! Go now! ...Read more

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Mom has pulmonary htn and mild mitral and tricuspid regurgitation. Do these play any role or complication in a radical laparo. Nephrectomy?

Severity?: Mild mr and tr would not increase her risk. Any significant elevation of pulmonary artery pressure would. It depends on severity. She obviously has had an echo. Check with her cardiologist to be sure she is medically as fit as she can be prior to major surgery. ...Read more

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Renal Cell Carcinoma - had radical nephrectomy left kidney, cancer has spread to the lungs - surgery not an option. Life expectancy w/o treatment?

Renal Cell Carcinoma - had radical nephrectomy left kidney, cancer has spread to the lungs - surgery not an option. Life expectancy w/o treatment?

RCC: The American Cancer Society reports the following five-year survival rates:
•stage 1: 81 percent
•stage 2: 74 percent
•stage 3: 53 percent
•stage 4: 8 percent ...Read more

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What exactly is a partial nephrectomy?

Kidney surgery: Partial nephrectomy refers to surgical removal of part of the kidney, usually because of a small tumor/abnormal growth of the kidney. A radical nephrectomy (total kidney removal) is done for larger tumors, or if the partial nephrectomy is not technically possible. ...Read more

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Is it possible to have a partial nephrectomy?

Is it possible to have a partial nephrectomy?

Yes: Depending on the size and location of the kidney mass, a partial removal of the kidney cancer is a very good option to help preserve the remaining good kidney tissue. This has in fact become the mainstay of treatment for many tumors and the long-term data shows good cancer control with partial removal versus removing the entire kidney, which was the traditional type of surgery in the past. ...Read more

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What is the definition or description of: nephrectomy?

Removal of kidney: Surgical removal of kidney for any number of causes. ...Read more

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What can one expect from a laparoscopic nephrectomy?

Small scar: Laparoscopic nephrectomy will result in small scar, minimum pain, early discharge from the hospital, just as safe as open nephrectomy. ...Read more

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What are the effects of a partial kidney nephrectomy?

What are the effects of a partial kidney nephrectomy?

Depends: A partial nephrectomy is becoming the new standard of care for tumors that can be manage this way. Patients on the long run do better and minimize their risk of developing kidney disease as they age. Partial nephrectomy is challenging & has the potential for more complications than a nephrectomy. Risks include bleeding, urine leaks, loss of function on that kidney, tumor recurrence to name few. ...Read more

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Anesthesia options during a partial or full nephrectomy?

Anesthesia options during a partial or full nephrectomy?

You'll have: General anesthesia. These are typically done laparoscopically, but if it will be open, you might also ask for an epidural for post op pain relief. ...Read more

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Urine has become slightly cola colored 6 years after nephrectomy. Should I be concerned?

Urine has become slightly cola colored 6 years after nephrectomy. Should I be concerned?

DARK urine=blood: Cola colored urine is a sign of blood. This certainly needs to be checked out soon. Be prepared to give a 'clean catch urine' in the doctors office for analysis. You may need a cat (ct) scan for further evaluation of your urinary tract as well as follow up with your urologist. ...Read more

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If one has a pretty bad cold and has a nephrectomy coming up in a week, is it wise to go or no?

If one has a pretty bad cold and has a nephrectomy coming up in a week, is it wise to go or no?

An upper respiratory: Infection should be cleared up prior to elective and semi-elective surgery. Having a URI during anesthesia can lead to intra-op complications like bronchospasm and respiratory collapse and post-op complications like pneumonia and prolonged intubation. Consider a preop course of antibiotics if appropriate. ...Read more

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What to expect for pre-op for nephrectomy surgery?

PRE-OP NEPHRECTOMY: Many doctors have many different preps. If the tumor very large a bowel prep is sometimes needed. ...Read more

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Is nephrectomy a very common procedure?

Nephrectomy: It is done quiet often by urologists. They have many ways of doing it, including robotically, traditionally with an incision and even laprascopically (small incisions using a scope and other tools). ...Read more

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What does it mean to have a partial nephrectomy?

What does it mean to have a partial nephrectomy?

Only part removed: A partial nephrectomy is when only part of one kidney is removed. A while ago it was standard to simply remove the entire kidney. Medical knowledge and surgical techniques now allow us to remove only the area of concern. This leaves you with more total kidney tissue and thereby more kidney function (cleaning capability) after the procedure. Good luck. ...Read more

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What type of surgeon does nephrectomy?

Urologist: In a large city or academic medical center, most nephrectomies are performed by urologists. Within urology, there are particular sub specialists who focus on kidney surgery including minimally invasive options. Transplant surgeons and vascular surgeons can also occasionally remove kidneys. In a more rural setting, a general surgeon may be the one performing this procedure in the absence of urology. ...Read more

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What causes hypertension after bilateral nephrectomy?

See below: After bilateral nephrectomy, you would need some form of dialysis or transplant, as lack of kidney function leads called CKD leads to higher blood pressure
besides salt excess, increase hormonal influences like increase angiotension and catecholamines also cause hypertension. ...Read more

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How dangerous is a laparoscopic nephrectomy surgery?

Depends: As long as your operation is done by an expert, it should be safe. Ask your sugeon how many he/she has done and about past results. It can be a very safe operation in the right hands. ...Read more

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What can cause hypertension post bilateral nephrectomy?

What can cause hypertension post bilateral nephrectomy?

Excess salt + water: With no kidneys dialysis is needed and excess intake and inadequate removal of salt and water during dialysis is the major factor that causes high blood pressure. ...Read more

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Will a new kidney function normally after just having a left and right nephrectomy?

Yes: I take it you are a recepient of a kidney transplant and your kidneys were causing harm to you so they were removed at the same time.
The new kidney will do the work of 2 as long as there is no rejection or infection. ...Read more

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What are the steps to take when a nephrectomy is preformed procedure wise? Dissection, anatomy to know, etc.

What are the steps to take when a nephrectomy is preformed procedure wise? Dissection, anatomy to know, etc.

Depends: If it is done through a laparoscope is different than a regular incision. Prep is easy - some wish to have a clean colon first. ...Read more

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I'm in rn school and having trouble obtaining information about the correct procedure for positioning a patient after a nephrectomy. Please help.?

I'm in rn school and having trouble obtaining information about the correct procedure for positioning a patient after a nephrectomy. Please help.?

It depends: It depends on where the doctor makes the incision and whether he/she is doing surgery lap, robotic or open. Campbell's urology, the definitive textbook on urology in your medical library should be a good reference. ...Read more

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How does a pain pump work after nephrectomy?

Depends upon type: Pain pumps are of varying types. Some use numbing medication and others use narcotics. ...Read more

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What is post nephrectomy hematoma, and is it dangerous?

What is post nephrectomy hematoma, and is it dangerous?

Bleed after surgery: Hematoma is a collection of blood. Means that nephrectomy patient either continued to or started to bleed after kidney removal surgery. Can be dangerous with large or massive hematomas which may require transfusion to correct blood loss, or surgical exploration to tie of bleeding vessel/s. ...Read more

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Had nephrectomy 15 years ago. I only have one normal funtioning kidney now, can I donate blood? Help

Had nephrectomy 15 years ago. I only have one normal funtioning kidney now, can I donate blood? Help

Probably: As long as your normal blood count is normal, you should be able to donate blood without affecting your kidney. But you should check with your nephrologist to be on the safe side. ...Read more

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Had nephrectomy 15yrs ago. I only have one normal functioning kidney now. Can I donate blood? Why yes and why not? Help

Had nephrectomy 15yrs ago. I only have one normal functioning kidney now. Can I donate blood? Why yes and why not? Help

Here are some. ..: Living with an acquired solitary kidney like you is not a contraindication to donate blood as long as you're healthy with no blood-borne transmitted diseases like HIV, hepatitis - B & C, syphilis, etc. But some restrictions for such may exist among different countries. So, ask your local institutions for details. ...Read more