Surgery to Treat Kidney Cancer
Surgery is the standard treatment standard for solid renal masses. There are several surgical options, depending on the size of the mass and the overall health of the patient.
When the tumor is small and confined to the top or bottom portion of the kidney, a partial nephrectomy (removal of part of the kidney) may be performed. This procedure also may be used to treat patients with masses in both kidneys and patients who have only one functioning kidney.
Radical nephrectomy is the most common treatment for solid renal masses. This procedure, which is performed under general anesthesia, involves removal of the entire kidney. It also may include removal of surrounding tissue and nearby lymph nodes including the adrenal gland.
Radical nephrectomy may be performed through a large abdominal or flank incision (open radical nephrectomy) or 4 or 5 smaller incisions (laparoscopic radical nephrectomy). In laparoscopic radical nephrectomy, an instrument consisting of a light and camera lens that produces magnified images (called a laparoscope) is used to allow the physician to see inside the abdomen.
Tiny instruments are inserted through the incisions and used to separate the kidney from surrounding structures (e.g., ureter, blood vessels). The physician then enlarges one of the incisions and removes the kidney.
Generally, the risk for complications and blood loss during surgery is similar in both procedures. Patients who undergo laparoscopic nephrectomy may require less pain medication, usually are discharged from the hospital sooner, and often are able to resume normal activities earlier.
Complications of nephrectomy include the following:
- Damage to surround organs (e.g., spleen, pancreas, large or small intestine) and blood vessels (e.g., aorta, vena cava)
- Failure of the remaining kidney
- Hemorrhage (excessive bleeding) during or after surgery
- Incisional hernia (protrusion of organs or tissue through the abdominal wall)
- Pneumothorax (air in the chest cavity, outside the lungs)