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Cytoreductive nephrectomy is recommended for kidney cancer patients whose cancer has spread to other tissue (metastatic). The goal of cytoreductive surgery is to remove as many cancer cells as possible. To do this, it may be necessary to remove surrounding organs as well. The spleen or the pancreas or parts of the intestines or the liver might be affected.

How is cytoreductive nephrectomy performed?

To undergo cytoreductive nephrectomy, you must be fit for surgery and have a tumour that can be removed. You will be asleep (general anaesthesia) during the operation. You will lie on your side or on your back, depending on the location and the size of the tumour. Cytoreductive nephrectomy is usually ‘open’, meaning that the surgeon will operate through an open cut (incision) in the body.
To begin, the tumour will be measured, and the doctor will see whether surrounding tissue or organs have been affected. Then the surgeon will cut the abdominal wall to access the kidney directly. To prevent the tumour from spilling cancer cells, the surgeon keeps the kidney covered with a protective layer of fatty tissue. The surgeon separates the tubes that connect to the kidney in order to remove it.

Cytoreductive partial nephrectomy

If the largest (primary) tumour in the kidney is not very large or if your other kidney is not working well, your doctor may recommend cytoreductive partial nephrectomy. This procedure is rarely done. The aim is to remove the part of the kidney with the tumour but to leave as much as possible of the healthy kidney tissue intact. This procedure can be done as open surgery or by making small cuts and inserting tube-like instruments that allow the surgeon to see inside the body (laparoscopy).

Metastasectomy

Your doctor may recommend additional surgery to remove the metastatic tumours. This is only advised if it is technically possible to remove the metastases and if you are fit to undergo major surgery. This procedure can help if you are in a lot of pain or have other symptoms which cause discomfort.

What are the side effects of the procedure?

After cytoreductive nephrectomy, you may have minor pain in the side of your body for several weeks.

You need to go to your doctor or go back to the hospital right away if you:

  • Develop a fever
  • Have any blood loss
  • Experience acute pain
  • Have blood in the urine

What is the impact of the treatment?

If cytoreductive nephrectomy is successful, it gives you the chance to live longer and you will have fewer side effects. After cytoreductive nephrectomy for kidney cancer, your doctor will generally recommend drug treatment.

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