Partial Nephrectomy

About

Partial nephrectomy — also called kidney-sparing surgery or nephron-sparing surgery — is an effective treatment option for people who have a single, small (less than 2 inches, or 5 centimeters) solid tumor and no other potentially complicating features such as scarring or kidney disease.

Partial nephrectomy

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Studies at Mayo Clinic have shown that removing just the portion of the kidney containing the tumor eliminates cancer just as effectively as removing the entire kidney, with no greater risk of recurrence. Hospital costs and lengths of stay are similar for both surgical procedures.

Equally important, a partial nephrectomy preserves some or most kidney function, which helps overall health. This is particularly critical for people with only one kidney who would otherwise require regular dialysis treatment or a kidney transplant after removal of the entire kidney (radical nephrectomy).

Evidence suggests risks associated with heart-related complications increase as kidney function declines with age. Therefore, people who can keep the function of more than one kidney have a better outlook as they age and their overall kidney performance decreases.

A Mayo study tracked two similar groups of people who had surgery for kidney cancers smaller than 1.5 inches (about 4 centimeters). It found that 93 percent of those who had a partial nephrectomy were still alive 10 years after their surgery, compared with 82 percent who had their entire kidney removed.

Another Mayo study looked at the use of partial nephrectomy in more-advanced stages of local cancers. It found that the risk of death (about 40 percent) was similar for people whether they had a partial nephrectomy or a radical nephrectomy. But the cancer recurrence rate (28 percent) at the last checkup was a bit lower for those who had a partial nephrectomy.

What to Expect

If your condition calls for removal of all or part of your kidney, your Mayo doctor will test your kidney function and order imaging exams. Based on the results, your care team will determine if you are a candidate for partial nephrectomy and whether laparoscopic or robot-assisted laparoscopic surgery is an option.

After surgery, the care team will closely monitor your progress to guard against complications from blood clots or infection, and to ensure you maintain normal urinary function.

As with any surgery, partial nephrectomy entails some risks. Generally, however, post-surgical risks associated with partial nephrectomy are manageable.

It is possible, though uncommon, that surgeons may be unable to preserve enough kidney function to avoid dialysis — the kidney disease may be too severe, or surgeons may need to remove more kidney tissue than anticipated. In such cases, the surgical outcome becomes similar to radical nephrectomy.

Hospital stays for partial nephrectomy can be as short as one to three days. Within two to three weeks, you should notice significant pain reduction.