肾癌手术的简单指南

肾切除术（这是肾手术的伞长医生使用）消除整个肾脏或只是其中的一部分。考虑到诸如CT或MRI的成像试验的结果，由泌尿科外科医生重量许多因素来确定需要多种因素来确定需要什么类型的肾切除术。无论您获得哪种手术类型，恢复的长度都可以持续三到六周，具体取决于许多事情，包括您的年龄和健康状况。如果手术后癌症返回，如果可能需要额外的手术，您的医生将讨论。点击通过学习手术类型，为什么每个人都有助于治疗肾癌。

A radical nephrectomy removes the entire kidney. According to Joseph D. Shirk, M.D., assistant professor of urology at David Geffen School of Medicine at UCLA, “In most cases, radical nephrectomies are done for large, invasive tumors where there is not much normal kidney remaining.” The surgeon can remove the kidney through a long incision (open radical nephrectomy), or via minimally invasive surgery, where small incisions are made. Minimally invasive surgery is typically performed either robotically or via a standard laparoscopy that relies on a special video camera called a laparoscope and thin-gauge instruments to cut away the kidney. Most (but not all) radical nephrectomies are now done with minimally invasive surgery, says Dr. Ponsky.

• Right after surgery:You may have a catheter draining urine from your bladder and possibly a small abdominal tube draining any excess fluids. Both are removed once you’re able to walk or before you’re discharged. Most patients resume normal eating the day after surgery.

• Complications:虽然罕见，您可以在腹壁或疝气中开发凸起，其中组织从切口突出。

• 跟进：Once or twice a year you’ll need a blood test that measures serum creatinine to gauge your kidney function, says Dr. Ponsky.

部分肾切除术去除肿瘤，留下健康的肾组织，使剩余器官能够继续从血液中去除废物的正常功能。这是早期肾癌的首选手术。可以通过已经讨论的开放方法或微创技术来完成部分肾切除术。根据Shirk博士的说法，“自从机器人手术的出现以来，”开放的部分肾切除术是罕见的，现在对于在难以使用外科机器人的地方难以使用多种肿瘤或肿瘤的患者。“

• Right after surgery:如果您有一个微创的方法，或者在三到四天内，您可以在同一天或在一到两天内出院。

• Complications:A hernia and bleeding are risks, because the kidney has a very rich blood supply—though “blood loss may be less with a robotic approach,” says Dr. Shirk. Also, if a tumor is very deep, urine may leak (the kidney produces urine) requiring another procedure to drain it.

• 跟进：您肯定可以是活跃的（爬楼梯，行走短距离），但与医生讨论任何活动以确定。

这种手术（AKA淋巴结解剖）可以在激进的肾切除术期间涉及去除位于癌肾附近的淋巴结。淋巴结是淋巴系统的一部分的小结构，其携带含有疾病的免疫细胞的流体。在手术前，如果MRI或CT扫描表明节点被扩大或者在操作期间感觉或看起来异常 - 也许表明癌症已经传播 - 您的外科医生可能决定删除它们。

• Right after surgery:您可能有一个导管排水尿液或小腹部管以排出多余的流体 - 两者都可以移走一旦你可以走路或在你出院之前。

• Complications:There’s a risk of bleeding as well as leakage of lymphatic fluid. Though rare, bleeding could be serious, requiring a blood transfusion. The lymphatic leak could resolve on its own in a few weeks to months or may require medication or an additional procedure.

• 跟进：Once or twice a year you’ll need a blood test that measures serum creatinine to gauge your kidney function, says Dr. Ponsky.

An adrenalectomy, which may be done during a radical nephrectomy, removes the adrenal gland that sits atop the cancerous kidney. The body has two adrenal glands, which are small, triangular-shaped organs that produce several essential hormones, including cortisol that’s involved with regulating the immune system, blood pressure, metabolism and the body’s response to stress. If the results of imaging tests (MRI or CT scan) shows that the cancer has spread from the kidney to the adrenal gland, your surgeon may decide to remove it.

• Right after surgery:您可能有一个导管排水尿液或小腹管排放过量的流体 - 一旦你能够走路或在你出院之前就会去除。

• Complications:有风险出血，虽然罕见，可能需要输血。在包括脾脏和肝脏的附近器官的损害也存在风险（虽然罕见）。最后，已经有报道肾上腺功能不全，其中没有产生足够的激素，需要补充皮质醇（例如泼尼松）。

• 跟进：Once or twice a year you’ll need a blood test that measures serum creatinine to gauge your kidney function, says Dr. Ponsky.