Open Partial Nephrectomy is the surgical procedure of removing the affected portion of the kidney and a certain amount of healthy kidney tissue through open surgery. The goal is to remove the tumor while preserving as much healthy kidney tissue as possible. The kidneys serve as the main filters in the human body, filtering the blood and converting it into urine. Therefore, the preservation of kidney function is targeted during the surgery. The removed portions are sent to the laboratory for evaluation. In addition to filtering the blood, the kidneys also regulate blood pressure, participate in bone metabolism, and contribute to blood production.
When is Open Partial Nephrectomy Needed?
- Cancer
- Infection
- Damage caused by kidney stones
- Injury due to trauma
- Congenital abnormalities
- Hypertension caused by problems in the blood supply to the kidneys
How is Open Partial Nephrectomy Performed?
During the surgery, the blood vessels entering and exiting the kidney are temporarily clamped to stop blood flow. The kidney can be cooled with ice to preserve as much kidney function as possible. After the removal of abnormal tissue from the kidneys, the clamps are removed, and blood flow resumes, causing the kidney to regain its normal color. Bleeding from the reconstructed part of the kidney is generally minimal.
What are the Advantages of Open Partial Nephrectomy over Radical Nephrectomy?
After Open Partial Nephrectomy, the patient can live with almost two fully functioning kidneys. This is preferred over radical (total) nephrectomy, where the entire kidney is removed. Open partial nephrectomy has the lowest rate of serious complications such as bleeding or kidney loss, allowing even the most challenging cases to be performed as safely as possible.
Most patients with one functioning kidney or reduced kidney function are treated with Open Partial Nephrectomy to preserve as much kidney function as possible. Tumors in the middle portion of the kidney (where the blood vessels enter and exit the kidney) are typically managed with an open approach.
What are the Complications and Risks of Open Partial Nephrectomy?
Like any surgery, Open Partial Nephrectomy carries certain complications and risks, including:
- Bleeding that may require blood transfusion
- Urinary incontinence, which is usually resolved with delayed healing
- Allergic reaction to anesthesia (rare)
- Kidney failure, depending on the functioning of the remaining kidney
- Postoperative pneumonia (lung infection)
- Blood clots in the legs that can travel to the lungs.
