What is a radical nephrectomy?
A radical nephrectomy is a type of surgery in which the entire kidney is removed during surgery. It is most frequently performed for the treatment of kidney cancer. Surgery is considered part of the treatment for most kidney cancers and the type of surgery we perform depends on the type and size of the tumor and extent of disease. In a radical nephrectomy surgery, the kidney, and often the adrenal gland and the surrounding lymph nodes are removed. Most people can function fine with just one kidney.
What to expect during a radical nephrectomy
Your child’s surgeon can perform a radical nephrectomy using either traditional open surgery or minimally invasive laparoscopic surgery. In both cases, your child will be given anesthesia to go to sleep and remain asleep during the procedure. In open surgery, the surgeon makes an incision (a cut) in the patient's abdomen to remove the kidney. The surgeon makes the incision across the side or in the front, just below the rib cage. This allows the surgeon to thoroughly examine the kidney and the surrounding tissue for any possible tumor spread. To completely remove the cancer, the surgeon removes the kidney and the lymph nodes around the kidney. It usually takes a few hours to perform this operation.
Laparoscopic radical nephrectomy is a minimally invasive surgical procedure, generally used for a very specific group of smaller, localized renal (kidney) tumors, or tumors that have not spread outside the kidney. For this procedure, the surgeon makes several small "key-hole" incisions in the abdomen. The surgeon inserts a tiny camera, or laparoscope, through the incision and uses specialized surgical instruments to perform the surgery and remove the kidney or tumor. In some cases, a somewhat larger incision is made to allow for easy removal of an intact kidney. The benefits to having a radical nephrectomy done laparoscopically usually include a shorter hospital stay, faster recovery and less pain afterwards.
The Solid Tumor Program at Children’s Hospital Colorado, which consists of a team of pediatric surgeons, pediatric urologists and pediatric oncologists, will often combine surgical methods with chemotherapy when treating pediatric kidney cancers.
What to expect after a radical nephrectomy
After the operation, your child will be taken to the recovery room until they are awake and vital signs (blood pressure, pulse and respiration) are stable. We’ll use medication to help relieve any pain or discomfort. Children typically stay in the hospital for 3 to 5 days before returning home.
Most children will not have a bowel movement for several days after surgery, which is a typical side effect of the painkillers given during surgery. Your child’s doctor will prescribe stool softeners and laxatives while your child is in the hospital and you should include a lot of fiber and fluid in their diet to help ease the constipation once they return home.
Liquids will be started after surgery and then their diet will be advanced to solid food if your child can tolerate it. It sometimes takes patients a few days to want to eat. It can take several days for the intestines to recover from the anesthesia and drinking or eating too much too soon can cause nausea and vomiting.
It takes approximately four weeks for the surgical area to heal completely. Your child should not do any heavy lifting or exert themselves during this time. Recovery time varies depending on each individual patient. Your child’s doctor will monitor this and discuss it with you during follow-up appointments.
Your child and your family will not go through this surgery alone. A radical nephrectomy can present a difficult emotional adjustment for your child and your family. Children’s Colorado provides support to help patients and families deal with this impact on their lives. A social worker is part of the team to care for patients while in the hospital, which you or your child can request to help provide emotional support during this difficult time. After discharge, the social worker can also provide names and contact information for support groups.
If you have any questions or concerns, call the ParentSmart Healthline toll free at 1-855-543-4636 (KID-INFO). Caring pediatric nurses are available 24/7 to help answer your health questions.
Why choose us for a radical nephrectomy
Our Solid Tumor Program team is known across the country for the excellent work they do. Some of our doctors specialize in very specific fields focused on urologic oncology and surgical oncology . Their expertise, along with the support they receive from their amazing staff, have helped Children’s Colorado excel in the surgical treatment of urologic tumors, especially when it comes to children.
In addition to using surgical techniques like minimally invasive surgery that help to reduce recovery time, our hospital is also set up to help reduce children’s anxiety and fears leading up to surgery. Our Child Life team helps explain the surgery to children in a way they understand and can even help put them at ease when they are taking medical tests prior to the surgery. And our pediatric anesthesiologists are specifically trained to work with kids and only kids, so they know exactly the right amount of medication to give to children and understand how children can react differently to it than adults.
A surgery like this is never fun, but we’ve designed a place that makes it as easy as possible on children and their family. Our kid-friendly space combined with our pediatric-trained doctors make it the best choice in the Rocky Mountain region for a nephrectomy or any other surgery.