Kidney-sparing surgeries for small kidney tumours

Advancements in medical technology and surgical techniques have led to significant improvements in the treatment of kidney tumors. Kidney tumors, also known as renal tumors, can be benign or malignant growths that develop within the kidneys. Traditionally, the treatment approach for kidney tumors involved the complete removal of the affected kidney, known as a nephrectomy. However, with the advent of kidney-sparing surgeries, patients with small kidney tumors now have a more precise and conservative option that preserves kidney function while effectively treating the tumor.

Understanding Kidney Sparing Surgeries

Kidney-sparing surgeries also referred to as partial nephrectomies or nephron-sparing surgeries, have emerged as a groundbreaking alternative to traditional nephrectomies. These procedures are specifically designed for patients with small kidney tumors, typically measuring 4 centimeters or less in diameter. The primary goal of kidney-sparing surgeries is to remove the tumor while preserving as much healthy kidney tissue as possible.

Types of Kidney Sparing Surgeries

There are two main types of kidney-sparing surgeries commonly performed:

Partial Nephrectomy: In this procedure, only the tumor and a small margin of healthy tissue surrounding it are removed, leaving the remaining kidney tissue intact. This is typically achieved through open surgery, laparoscopic techniques, or robotic-assisted procedures. Partial nephrectomies are highly effective for treating small kidney tumors and have been associated with better long-term kidney function outcomes.
Radiofrequency Ablation (RFA) and Cryoablation: These minimally invasive techniques involve using either heat (RFA) or extreme cold (cryoablation) to destroy the tumor cells. During RFA, a special probe is inserted into the tumor, and high-frequency electrical currents are applied to heat and kill the cancerous tissue. In cryoablation, a probe is used to freeze and destroy the tumor. These procedures are especially useful for patients who are not candidates for surgical removal due to various factors.

Techniques of Kidney Sparing Surgeries

Open Partial Nephrectomy: This traditional approach involves making a large incision in the abdomen to access the kidney. The surgeon carefully removes the tumor along with a margin of healthy tissue, and the incision is closed. While effective, this technique often involves a longer recovery period and a higher risk of complications.
Laparoscopic Partial Nephrectomy: In this minimally invasive approach, small incisions are made in the abdomen through which specialized surgical instruments and a camera are inserted. The surgeon removes the tumor using these instruments while watching a video feed from the camera. This technique offers quicker recovery times and fewer complications compared to open surgery.
Robotic-Assisted Partial Nephrectomy: Building on laparoscopic techniques, robotic-assisted surgeries employ a robotic system controlled by the surgeon to perform precise movements. This enhances the surgeon's dexterity and offers a 3D visualization of the surgical site, making tumor removal more precise and minimizing damage to healthy tissue.

Symptoms of a kidney tumor

Symptoms of a kidney tumor may include:

Blood in Urine: Sometimes, blood can make the urine pink, red, or brown, which is called hematuria.
Pain on the Side or Back: Feeling a dull ache or pain on your side or back, below the ribs, could be due to a kidney tumor.
Lump or Swelling: You could feel a lump or notice a swelling in your belly or side.
Feeling Tired: Unusual tiredness or weakness might be present, even without much activity.
Weight Loss: Losing weight without trying could be a sign.
Fever and Sweating: Fever that comes and goes, along with night sweats, could occur.
Anemia: Anemia, which is when you don't have enough red blood cells, might make you look pale and feel weak.
High Blood Pressure: If your blood pressure is consistently high and not responding to regular treatments, it might be linked to a kidney issue.
Swelling in Legs and Ankles: Swelling in your legs or ankles, like they're puffy, might point to kidney issues.
Loss of Appetite: You might not feel like eating as much as usual.

Note: Incidental Detection- The majority of Kidney tumours are eligible for kidney-sparing surgeries are detected incidentally, during imaging done(Ultrasound, CT scan, MRI scan) for other clinical reasons. Hence these tumors may not manifest any of the above-mentioned symptoms. Those with a family history of cancers are encouraged to do ultrasound & other cancer screening tests for early detection of such tumors.

Benefits of Kidney Sparing Surgeries

Preservation of Kidney Function: The most significant advantage of kidney-sparing surgeries is the preservation of kidney function. Since only the tumor and a minimal amount of healthy tissue are removed, the remaining kidney tissue continues to function effectively, reducing the risk of kidney-related complications.
Reduced Risk of Chronic Kidney Disease: Patients who undergo kidney-sparing surgeries have a lower likelihood of developing chronic kidney disease, which can be a debilitating condition requiring ongoing medical management.
Prevention of Kidney Failure: Kidney-sparing surgeries play a crucial role in preventing kidney failure, as the retained healthy tissue maintains the kidneys' ability to filter waste and regulate bodily functions.
Faster Recovery: Minimally invasive techniques, such as laparoscopic and robotic-assisted surgeries, offer quicker recovery times compared to traditional open surgery. This allows patients to return to their normal activities sooner, improving their quality of life.
Lower Risk of Cardiovascular Complications: Kidney health is closely linked to cardiovascular health. Preserving kidney function through kidney-sparing surgeries can contribute to a reduced risk of cardiovascular complications in the long run.
Increased Treatment Options: Kidney-sparing surgeries expand treatment options for patients who might not be suitable candidates for complete kidney removal (nephrectomy), such as those with pre-existing kidney conditions.
Long-Term Peace of Mind: Patients who undergo kidney-sparing surgeries can enjoy peace of mind knowing that they have received effective treatment for their kidney tumor while safeguarding their kidney function for the years to come.

Conclusion

Kidney-sparing surgeries have revolutionized the treatment of small kidney tumors, providing patients with an effective and less invasive alternative to complete kidney removal. With their ability to preserve kidney function, reduce the risk of chronic kidney disease, and offer quicker recovery times, these procedures have become a cornerstone of modern urological care. As medical advancements continue to evolve, kidney-sparing surgeries will likely play an even more significant role in enhancing patient outcomes and quality of life. If you are facing the prospect of kidney tumor treatment, it is crucial to consult with a qualified urologist, especially one experienced in nephron-sparing surgery in Bangalore at Sakra World Hospital, to determine the most appropriate approach based on individual circumstances.