Usually, in serious kidney pathologies, doctors are forced to resort to surgical treatment, during which tissues that are prone to pathologically irreversible changes are removed. If you previously had to remove the kidney, then today's surgeons try to preserve the integrity of the organ as much as possible. To do this, instead of nephrectomy, patients undergo a renal resection, during which only the damaged tissue is cut off.
Resection of the kidney
A resection of the kidney is called an operative intervention, during which the surgeon runs out a part of the renal tissue prone to pathological lesions. This operation allows you to maintain the functionality of the body, it is much safer than nephrectomy and helps reduce the burden on the second kidney.
By resection, the patient can be rid of some tumor formations, not only benign, but also of malignant origin. Thanks to this technique today, the number of nephrectomy operations has significantly decreased.
Today two interventional techniques are distinguished:
- Laparoscopic resection of the kidney - the intervention is carried out by means of special equipment that is injected into the patient's body through small punctures.
- Open resection of the right or left kidney is a standard surgical intervention with a large incision and open access to the diseased kidney.
The mode of intervention is selected in accordance with the nature of the disease and the degree of damage to the tissues of the organ.
Indications and contraindications
Renal resection is prescribed for a sufficiently wide range of pathological conditions, in which partial damage to the organ tissues is observed, since only in such a clinical picture can the resection be able to guarantee the patient's recovery. Most often partial renal resection is used for tuberculosis or polycystic kidney disease, as well as for highly cancerous tumors.
Specialists also perform a resection in the presence of such factors:
- With the active growth of benign education;
- For damage not exceeding 4 cm;
- Bilateral renal oncology;
- High probability of malignancy of pathological organ damage;
- High probability of kidney failure;
- Traumatic organ damage;
- Urolithiasis with locus of calculus in the bottom of calyx.
If onkobrazovanie takes place, the intervention is carried out as accurately as possible, because if at least a cell of malignant tissue remains on the kidney, the oncogenesis will form again. More often when cancer tumors doctors do not want to take risks, so they remove the kidney entirely. Resection for a kidney tumor
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Contraindications for renal resection include conditions in which intervention can lead to the development of all sorts of unsafe complications. The operation is contraindicated for obesity of extreme degree, infectious pathologies, violations of hemostasis activity or late gestation.
Before resection, the patient is referred for a qualitative preoperative examination with the delivery of all necessary tests. For the operation, one must go hungry( there are not 12 hours) and without chronic pathologies. The doctor pays special attention to respiratory infections or pulmonary inflammation, if pneumonia or bronchitis is detected, the operation is canceled. For the completeness of the clinical picture, before the intervention,
- Magnetic resonance or computed tomography;
- Ultrasound examination;
- Nephroscintigraphy is a radioisotope diagnosis using nephrotropic radiopharmaceuticals;
- Excretory urography is an x-ray study with contrast.
When the examination is completed, the tests are handed over, the date of the operation is assigned. Immediately before resection, the patient is measured by blood pressure.
The procedure is performed using general anesthesia. The patient is neatly but firmly fixed on the operating table, placing a special roller under the healthy side. If resection is supposed to be an open method, the surgeon will make a cut of about 12 cm long. Then he cuts through the tissue layer by layer, making his way to the affected kidney. The organ foot is clamped with a special surgical instrument. The use of a clamp is necessary to control the bleeding.
If laparoscopic resection is supposed, then the size of the cut is not more than 3-4 cm. Then the equipment is inserted into the incision, followed by the surgeon following the monitor. After the clamp is inserted, the cut tissue is cut off. Removal tactics are used in a wedge shape, resulting in two identical flaps that are shifted and sewn together.
After resection, a drainage system is introduced to the removal site to monitor the discharge of the liquid. Then the surgeon sews a cut on the body.
On video laposkopicheskaya resection of the right kidney:
In the postoperative period, the time for the final restoration is necessary.
Minimizing the likelihood of complications will help to comply with some post-operational rehabilitation and recovery rules:
- Drink more water;
- Eliminate physical overload;
- It is necessary to discuss with a specialist what kind of diet and nutrition will be before discharge;
- Every couple of months it is necessary to undergo examination;
- Eliminate stress and nerve stress;
- During the rehabilitation period, monitor the suture material daily, make dressings, etc.;
- When recovering from surgery, the body is especially vulnerable to infectious processes, so you do not need to contact patients and be sure to avoid hypothermia.
Consequences and complications
Like other surgeries, complications and undesirable consequences also develop after kidney resection. Already during the intervention, bleeding may open, any neighboring organ may get injured, an infectious agent will penetrate. With the penetration of the infection, purulent processes develop, and among the consequences, external fistulas can be caused by the formation of a hernia or parainal hematoma, pneumonia or necrosis of the renal tubules, in which the kidney, venous thrombosis, etc., aches.
After the operation, it will be necessary to visit a specialist on certain days,blood, ultrasound diagnostics, diet therapy and other measures. If after a 5-year period there is no malignant predisposition, the patient is removed from the register.