What is a nephrectomy (surgical removal of a kidney)?

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Last updated: March 2, 2025 • View editorial policy

From the Guidelines

A nephrectomy is a surgical procedure that involves the removal of a kidney, which can be performed as a radical nephrectomy or partial nephrectomy, with the choice of procedure depending on the size and location of the tumor, as well as the patient's overall health and kidney function, as recommended by the ESMO clinical practice guideline for diagnosis, treatment, and follow-up of renal cell carcinoma 1.

Types of Nephrectomy

  • Radical nephrectomy: involves the removal of the entire kidney along with surrounding tissues and sometimes the adrenal gland
  • Partial nephrectomy: involves the removal of only the diseased portion of the kidney while preserving the healthy tissue, which is the preferred option for T1 tumors (≤7 cm) with normal contralateral kidney function, as it is associated with significantly better preservation of renal function 1

Surgical Approaches

  • Open surgery: involves a large incision and is typically used for more complex cases, such as locally advanced RCC (T3 and T4) 1
  • Laparoscopic surgery: involves several small incisions and is often used for minimally invasive radical nephrectomy, particularly for T2 tumors (>7 cm) 1
  • Robotic-assisted surgery: involves the use of a robotic system to assist with the surgery and is often used for partial nephrectomy, as it allows for more precise dissection and reconstruction of the kidney 1

Indications for Nephrectomy

  • Kidney cancer: nephrectomy is often the primary treatment for renal cell carcinoma, with the goal of removing the tumor and preserving as much healthy kidney tissue as possible 1
  • Severe kidney damage: nephrectomy may be necessary in cases of severe kidney damage due to trauma or disease, in order to prevent further complications and improve quality of life
  • Non-functioning kidney: nephrectomy may be necessary in cases of a non-functioning kidney due to disease or obstruction, in order to prevent further complications and improve quality of life

Post-Operative Care

  • Recovery time: varies depending on the surgical approach, with laparoscopic and robotic procedures generally allowing for shorter hospital stays and quicker recovery 1
  • Lifestyle adjustments: patients may need to make lifestyle adjustments to protect their remaining kidney, including maintaining proper hydration, following a healthy diet, and regular medical follow-ups to monitor kidney function, in order to minimize the risk of morbidity and mortality and improve quality of life 1

From the Research

Definition and Purpose of Nephrectomy

  • Nephrectomy is the surgical removal of a kidney, which is the mainstay of treatment for individuals with localized kidney cancer 2.
  • The primary goal of nephrectomy is to remove the cancerous kidney tissue while preserving as much renal function as possible 3.

Types of Nephrectomy

  • There are two main types of nephrectomy: radical nephrectomy and partial nephrectomy 4.
  • Radical nephrectomy involves the removal of the entire kidney, while partial nephrectomy involves the removal of only the cancerous portion of the kidney 4.
  • Partial nephrectomy is the preferred treatment for technically feasible lesions, as it helps to preserve renal function and minimize the risk of chronic kidney disease 4.

Indications and Outcomes

  • Nephrectomy is commonly performed for localized kidney cancer, and the outcomes depend on various factors, including preoperative renal function, volume of renal mass preserved, and surgical renal ischemia 4.
  • The decline in renal function after partial nephrectomy averages approximately 20% in the operated kidney, and can be due to incomplete recovery from the ischemic insult or loss of nephron mass related to parenchymal excision or collateral damage during reconstruction 3.
  • Chronic kidney disease (CKD) is a potential complication of nephrectomy, and it is associated with a higher cardiovascular and mortality risk 5.

Evolution of Nephrectomy Techniques

  • The techniques used for nephrectomy have evolved significantly over the years, from traditional open approaches to minimally invasive and robotic-assisted surgeries 6.
  • The use of laparoscopic and robotic approaches has reduced the morbidity of the partial nephrectomy procedure and improved renal functional and oncological outcomes 4.
  • The development of new surgical techniques and technologies has enabled surgeons to perform nephrectomies with greater precision and minimal damage to the surrounding tissue 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.