nefrektomie

Nefrektomi, also known as nephrectomy, is a surgical procedure to remove one kidney. It can involve removal of the entire kidney (radical nephrectomy) or only the diseased portion (partial nephrectomy, nephron-sparing surgery). The goal is to treat disease while preserving as much healthy renal tissue as possible when feasible.

Indications include treatment of localized renal cell carcinoma or other renal tumors, a nonfunctioning or severely damaged kidney due to chronic infection, obstruction, stones, or trauma, and, in living donation, the removal of a healthy kidney for transplantation. In partial nephrectomy, the aim is to remove the tumor with a margin of healthy tissue while maintaining renal function in the remaining kidney.

Surgical approaches have evolved from open procedures to minimally invasive techniques. Radical nephrectomy can be performed through open, laparoscopic, or robotic-assisted methods. Partial nephrectomy is commonly done laparoscopically or robotically, especially for small to medium-sized tumors, and aims to maximize preservation of renal tissue and function.

Preoperative evaluation includes assessment of renal function, imaging studies to define anatomy and tumor characteristics, and general medical optimization. For living donors, comprehensive evaluation ensures suitability and safety for donation. Perioperative care focuses on fluid management, pain control, and early mobilization; many patients resume normal activities within weeks, depending on the approach and individual recovery.

Risks include bleeding, infection, injury to surrounding structures, urine leakage, and temporary or permanent decline in kidney function. Long-term prognosis depends on the underlying condition and remaining renal function; in living donation, the remaining kidney typically adapts to maintain overall renal function.