Nephrectomy, or surgical removal of the kidney involves many risks. A recent study provides insights into the true risks of all types of nephrectomy.
By analyzing data on 21,380 nephrectomies performed throughout the United Kingdom, investigators found several lines of evidence to suggest that UK surgeons are highly competent.
‘Nephrectomy is done to treat kidney cancer as well as other kidney diseases and injuries. Nephrectomy is also done to remove a healthy kidney from a donor (either living or deceased) for transplantation.
The 30-day mortality rate after nephrectomy was only 0.5%. Also, mortality rates following radical, partial, and simple nephrectomy were 0.6%, 0.1%, and 0.4%, respectively.
Established risk factors were confirmed: old age, co-morbidities, significant blood loss and advanced stage of disease. The study also identified modest blood loss (~1L) and conversion from minimally invasive to open surgery as potential new risk factors.
"This pan-national study provides fresh insights into the contemporary risk of death following all types of nephrectomy and identifies potential novel risk factors for death," said Archie Fernando, lead author of the BJU International study.
Types of Nephrectomy
There are two types of nephrectomy for a diseased kidney: partial and radical. In partial nephrectomy, only the diseased or injured portion of the kidney is removed.
Radical nephrectomy involves removing the entire kidney, along with a section of the tube leading to the bladder (ureter), the gland that sits atop the kidney (adrenal gland), and the fatty tissue surrounding the kidney.
When both kidneys are removed at the same time, the procedure is called bilateral nephrectomy.
Possible complications of nephrectomy surgery include:
- Bleeding (hemorrhage) requiring blood transfusion
- Post-operative pneumonia
- Rare allergic reactions to anesthesia
There is also the small risk of kidney failure in a patient with lowered function or disease in the remaining kidney.
"Massive thanks to all the surgeons who contributed their data making this sort of comprehensive study possible," she added.