Partial Nephrectomy
What is Partial Nephrectomy ?
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Why do you need Partial Nephrectomy ?
Partial nephrectomy is indicated for:
- Kidney cancer:
- Renal cell carcinoma (RCC, 90% of kidney cancers; 3–5 per 100,000 in India).
- Small tumors (<4–7 cm, T1 stage; 60–70% of RCC cases are now detected early due to imaging).
- 5-year survival: 90–95% for localized RCC (T1); better functional outcomes than radical nephrectomy.
- Benign conditions:
- Benign tumors (e.g., oncocytoma, angiomyolipoma, if symptomatic).
- Localized kidney damage (e.g., trauma, infection, if isolated).
- Special cases:
- Solitary kidney, bilateral tumors, or chronic kidney disease (CKD) to preserve renal function.
- Associated treatments:
- Lymph node sampling (if high-risk cancer).
- Adjuvant therapy (e.g., immunotherapy like pembrolizumab) for high-risk RCC post-op.
- Timing:
- Performed in adults (average age 50–70 years for RCC); urgency depends on tumor growth (e.g., active surveillance for very small tumors).
The procedure aims to remove the tumor with clear margins, preserve kidney function, and reduce the risk of long-term dialysis, often using minimally invasive techniques to minimize recovery time.
Why Do Costs Vary in Philippines?
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Partial Nephrectomy Procedure
- Before Surgery Evaluation:
- Assessment:
- Imaging: CT/MRI to assess tumor size, location, and depth (e.g., near renal artery or collecting system).
- Blood tests: Kidney function (creatinine, eGFR); blood sugar, clotting profile.
- Split renal function test (e.g., DMSA scan): Ensures remaining kidney function post-op.
- Preparation: Optimize kidney function; stop blood thinners (e.g., aspirin) 5–7 days prior if safe.
- Consent: Risks, including bleeding, are explained.
- Assessment:
- Surgical Techniques:
- Partial Nephrectomy:
- Performed under general anesthesia, lasting 2–4 hours.
- Approaches:
- Open partial nephrectomy: Incision (10–15 cm) in flank or abdomen; for complex tumors.
- Laparoscopic partial nephrectomy: 3–4 small incisions (5–10 mm); camera and instruments used.
- Robotic-assisted (e.g., da Vinci): Most common for partial; enhances precision, especially for complex tumors.
- Process:
- Kidney exposed; renal artery clamped (warm ischemia time <20–30 minutes to minimize damage).
- Tumor excised with margin (0.5–1 cm of healthy tissue); sent for pathology to confirm clear margins.
- Kidney defect repaired: Sutures to close collecting system (if entered) and renal parenchyma.
- Hemostasis: Hemostatic agents (e.g., Floseal) or sutures to control bleeding.
- Closure: Sutures for laparoscopic/robotic; sutures/staples for open; drain placed.
- Intraoperative Tools:
- Intraoperative ultrasound: Defines tumor margins.
- Robotic system: Enhances precision for suturing.
- Mannitol: IV diuretic to protect kidney during ischemia.
- Partial Nephrectomy:
- After Surgery:
- Hospital stay: 2–4 days (laparoscopic/robotic); 4–6 days (open).
- Care: Monitor kidney function (creatinine); drain removed in 2–3 days; hydrate well.
- Pain management: Moderate pain for 3–5 days; managed with painkillers (e.g., paracetamol).
- Instructions: Avoid heavy lifting for 6–8 weeks; monitor blood pressure (remaining kidney compensates).
Recovery After Partial Nephrectomy
- Hospital Stay: 2–4 days (laparoscopic/robotic); 4–6 days (open).
- Post-Surgery Care:
- Pain/Swelling: Moderate pain for 3–5 days; resolves in 1–2 weeks.
- Activity: Avoid strenuous activity for 6–8 weeks; light activities in 1–2 weeks.
- Incision: Laparoscopic scars (small, 5–10 mm) fade in 3–6 months; open scar (10–15 cm) fades in 6–12 months.
- Kidney function: Stabilizes in 1–2 months; typically 70–90% of pre-op function preserved (better than radical nephrectomy).
- Diet: Hydrate well; low-sodium diet to reduce kidney strain; avoid NSAIDs long-term.
- Follow-Up:
- Visits at 1 week (check healing), 1 month, and every 3 months for 2 years (cancer recurrence risk).
- Imaging: CT at 3–6 months for RCC surveillance; kidney function tests (creatinine, eGFR) annually.
Most resume normal activities in 3–4 weeks (laparoscopic) or 4–6 weeks (open); full recovery takes 6–8 weeks. Success rate: 5-year survival for localized RCC is 90–95%; local recurrence rate is 2–5% with clear margins.
Risks and Complications
- Surgical Risks:
- Bleeding (5–10%): During or post-op; may need transfusion or reoperation (1–2%).
- Infection (2–5%): At incision site; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
- Post-Surgery:
- Urine leak (2–5%): From kidney repair site; may need stent or drainage.
- Kidney function decline (5–10%): Temporary rise in creatinine; usually stabilizes; dialysis rare (<1%).
- Margin positivity (1–3%): Cancer at margins; may need radical nephrectomy.
- Injury to nearby organs (1–2%): Spleen, bowel; rare with experienced surgeons.
- Long-Term:
- Recurrence (2–5%): Cancer return; needs regular imaging.
- Hypertension (3–5%): From kidney stress; managed with medication.
Report fever, severe pain, decreased urine output, or swelling promptly.
Frequently Asked Questions (FAQs)
What causes the need for partial nephrectomy?
Kidney cancer (RCC), benign tumors, or localized kidney damage; often chosen to preserve kidney function.
Can I avoid partial nephrectomy?
Yes, if very small tumor: Active surveillance or ablation (e.g., RFA); surgery needed for larger tumors or growth.
Is partial nephrectomy painful?
Moderate pain for 3–5 days, managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: 1–2 weeks; full recovery: 6–8 weeks; avoid strenuous activity for 6–8 weeks.
Is partial nephrectomy covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe pain, decreased urine output, or swelling.
Will my kidney function be normal after surgery?
Mostly: 70–90% of pre-op function preserved; better than radical nephrectomy; monitor long-term.
Lifestyle changes post-surgery?
Stay hydrated, follow low-sodium diet, avoid kidney strain (e.g., NSAIDs), and attend follow-ups.
Conclusion
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Looking for Best Hospitals for Partial Nephrectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.