KIDNEY REMOVAL

General Information

DEFINITION--Removal of a kidney.

BODY PARTS INVOLVED--Kidney; blood vessels connected to kidney; ureter.

REASONS FOR SURGERY

• Cancer or suspected cancer of the kidney.
• Kidney transplants to treat kidney failure.
• Severe kidney trauma.
• Dysfunctional kidney due to infection.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity.
• Smoking.
• Newborns and infants.
• Poor nutrition.
• Recent or chronic illness.
• Alcoholism.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--General surgeon or urologist.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of kidneys, chest and lower gastrointestinal tract; ECG; sonogram or CT scan (See Glossary for all).
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made, usually in the left or right flank, but sometimes in the abdomen.
• The vein leading from the kidney is located, isolated and tied.
• The ureter is located, tied and cut away from the kidney.
• The artery that supplies blood to the kidney is clamped in two places and cut between the clamps.
• The kidney is freed of adhesions or adjoining connective tissue and removed.
• All disconnected blood vessels are tied, and the muscles are closed with sutures. The skin is closed with sutures or clips, which usually can be removed in about 1 week after surgery.
• Surgery may be done by laparoscopy (see in Surgery section).

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Inadvertent injury to the vena cava or other organs near the kidney.

AVERAGE HOSPITAL STAY--5 to 7 days.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 4 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

MEDICATION---

Your doctor may prescribe:

• Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need. > Stool softeners to prevent constipation. > Antibiotics to fight infection.

ACTIVITY

• Resuming daily activities, including work, as soon as you are able can help the healing process.
• Avoid vigorous exercise for 6 weeks after surgery.
• Resume driving 5 weeks after returning home.
• Resume sexual relations when your doctor determines that healing is complete.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea, vomiting, constipation or abdominal swelling.