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Open Radical Nephrectomy

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Biotechnology That is Used to Cure Kidney Cancer

 

 

Open Radical Nephrectomy

Questions for Dr. Landman
 

Definition:
Open radical nephrectomy is defined as removal of the entire kidney with surrounding fat and adrenal gland via an open flank or abdominal incision.

Technique:
Under general anesthesia, the kidney is removed along with the surrounding structures such as the adrenal gland and lymph nodes. Occasionally, open radical nephrectomy requires removal of a rib or placement of a drainage tube within the chest cavity to complete the operation.

Candidates:
Candidates for open radical nephrectomy are generally patients with large kidney cancers that are greater than 10 cm (approximately 4 inches) in size. Also, patients who have had extensive prior surgery are good candidates for open radical nephrectomy as laparoscopy can be very challenging if there is a large amount of scarring in the space around the kidney. Finally, if there is evidence that the kidney cancer has involvement of organs around the kidney, then open radical nephrectomy is often the best procedure.

Advantages / Disadvantages:
The advantages of open radical nephrectomy is that the larger incision that is created allows the surgeon to deal with complex cancers, which involve structures around the kidney. Kidney cancer can involve organs around the kidney such as the pancreas, spleen, and liver. With open radical nephrectomy, the surgeon will have the best ability to access and control these structures if they are involved by the kidney cancer.

The disadvantages of open radical nephrectomy are predominantly related to short-term post-operative pain control as the procedure is four to five times more painful than the laparoscopic radical nephrectomy. Additionally, in comparison to laparoscopic radical nephrectomy, the open radical nephrectomy is typically associated with a longer recovery period and complete recovery.

The Procedure:
The procedure involves total removal of the kidney with or without the adrenal gland and surrounding lymph nodes by traditional surgical techniques.

Follow-up
The standard follow-up for open radical nephrectomy is dependent on the individual patient’s pathology report as different types of kidney cancer have different natural courses. Some kidney cancers require close “surveillance” (monitoring after the surgery) as they are more aggressive. Other types of kidney cancer are less aggressive and can be safely followed a little less frequently. Follow-up surveillance usually involve simple imaging studies. In cases where the kidney cancer is thought to have spread outside the kidney and tissues that have been removed during the procedure, some patients are offered additional treatment. This post-operative systemic therapy is offered and given in patients with a high risk of disease recurrence.

 

 

 
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Percutaneous Renal Cryoablation

Laparoscopic Partial Nephrectomy

Laparoscopic Radical         Nephrectomy

Robotic Partial Nephrectomy

Complementary Mangement Strategies

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How common is metastatic kidney cancer?

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Treatment for Metastatic Kidney Cancer

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How is metastatic kidney cancer treated?

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