تعريف
In a radical nephrectomy, the whole kidney is removed. In a partial nephrectomy, only a piece of the kidney is removed.
أسباب هذا الإجراء
Kidney removal may need to be done because of:
- Birth defects
- Injuries to the kidney
- العدوى
- ورم
- Kidney donation for a transplant
المضاعفات المحتملة
Complications are rare. But, no procedure is completely free of risk. If you are planning to have a nephrectomy, your سيقوم الطبيب بمراجعة القائمة of possible short-term complications, which may include:
- العدوى
- نزيف
- Blood clots
- تلف الأعضاء المجاورة
- Reactions to the anesthesia
- Leakage of urine from the remaining kidney tissue, if only part of the kidney is removed
Long-term complications from decreased kidney function may include:
- ضغط دم مرتفع
- فشل كلوي مزمن
تشمل العوامل التي قد تزيد من خطر حدوث مضاعفات ما يلي:
- التدخين
- Prior kidney surgery
- السمنة
- إدمان الكحول
- سوء التغذية
ما يمكن توقعه
قبل الإجراء
Your blood type is checked. This is done in case a transfusion is needed before or after surgery.
التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
- الأسبرين أو غيره من العقاقير المضادة للالتهابات
- مميعات الدم
Do not eat or drink after midnight before the procedure. You may need to take medicine to cleanse your bowels.
التخدير
General anesthesia will be given. You will be asleep.
الوصف الداخلي
A tube called a catheter will be inserted. An incision will be made in the abdomen or side of the abdomen. A rib may need to be removed to access the kidney. The tube from the kidney to the bladder is known as the ureter. If the whole kidney is being removed, the ureter and blood vessels will be cut. The kidney or part of the kidney will then be removed. The incision will be closed.
Laparoscopic surgery may also be used for a nephrectomy. The abdominal cavity will be inflated with gas. Several keyhole incisions are made in the area. A laparoscope, a long tool with a camera on the end, will be inserted through one of the holes. This allows the doctor to see inside you. Tools will be inserted through the other holes to perform the surgery. The same steps will be used to detach the kidney. A small incision will be made to remove the kidney.
كم من الوقت سيستغرق ؟
Between 2-4 hours
كم هو مؤلم ؟
Anesthesia will prevent pain during the surgery. Recovery is usually painful because of the location of the incision. The laparoscopic approach is much less painful. Your doctor will give you medicine to manage the pain.
متوسط الإقامة في المستشفى
The typical hospital stay after a nephrectomy is 2-7 days. The exact length depends on the نوع الجراحة. Your doctor may choose to keep you longer if complications occur.
رعاية ما بعد العملية
في المستشفى
IV fluids and pain medicine will be given after surgery. Blood pressure, electrolytes, and fluid balance will all be carefully monitored. A urinary catheter is often needed for a short time following surgery.
You will be encouraged to move around and be cautiously active as symptoms allow.
في البيت
Avoid difficult exercise or activities for about six weeks. Be sure to follow your doctor’s instructions. Ask your doctor about when it is safe to shower, bathe, or soak in water.
If both kidneys are removed, hemodialysis or kidney transplantation is necessary.
استدعاء الطبيب
بعد مغادرة المستشفى، اتصل بطبيبك في حالة حدوث أي مما يلي:
- علامات العدوى ، بما في ذلك الحمى أو القشعريرة
- احمرار أو تورم أو ألم متزايد أو نزيف مفرط أو إفرازات من موقع الشق
- Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which last for more than two days after you leave the hospital
- ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
- سعال أو ضيق في التنفس أو ألم في الصدر
- Difficulty urinating
- الضعف المفاجئ
في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.