Nephron sparing surgery

Also known as: partial nephrectomy, kidney surgery

Nephron sparing surgery (NSS), also known as partial nephrectomy, is kidney surgery where only part of the kidney is removed. It is most often performed as a first step in the treatment certain types of kidney cancer. Kidney surgery is usually performed by a urologist.

Surgery overview
Nephron sparing surgery (NSS), also known as partial nephrectomy, is kidney surgery where only part of the kidney is removed. It is most often performed as a first step in the treatment certain types of kidney cancer. Kidney surgery is usually performed by a urologist.

Why it is done
Traditional treatment for kidney cancer is the surgical removal of the entire kidney and some of the surrounding tissues (called a radical nephrectomy). With NSS only the tumor and tissue immediately surrounding the tumor is removed, leaving behind a still-functioning kidney.

NSS may be performed if:

  • The cancer is early stage
  • Tumors are small and located near the outside or edges of the kidney or are located in both kidneys
  • There are other needs to maintain a functioning kidney. For example, the opposite kidney has been removed or is at risk of long-term loss of function
  • The patient is young

How it is done
If open kidney surgery is performed, the surgeon gains access to a patient’s kidney through an incision in the front or side of the patient’s abdomen.

Some types of kidney surgery can be performed using minimally invasive techniques, where the surgeon accesses the kidney through one or more small incisions. Minimally invasive techniques are used because the smaller incisions often result in less pain, quicker recovery and less scarring. Not all patients are candidates for minimally invasive surgery, though. Patients must discuss their surgical options and the associated risks carefully with their surgeon.

Risks
Risks include those associated with any type of major surgery such as bleeding, blood clots, infection and problems with anesthesia. Additional risks associated specifically with NSS include:

  • Tumor recurrence
  • Damage to the kidney or kidney complications during surgery
  • Hemorrhage
  • Less-frequent complications include urinary leakage or fistula formation, renal artery thrombosis and acute renal failure

There are other risks associated with utilizing minimally invasive techniques to perform NSS. Patients should carefully discuss all risks with their surgeons and make sure they fully understand them before undergoing surgery.

Learn more
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