Our Summary

This research paper looks at the safety and results of a specific type of kidney surgery performed on people aged 80-89 years old. The study used a large database from the American College of Surgeons to gather information. They included patients who had either a minimally invasive partial nephrectomy (removing part of the kidney) or a radical nephrectomy (removing the whole kidney) between 2016 and 2020.

The study found that most of these patients (73.6%) had a full kidney removal, while 26.4% had part of their kidney removed. The researchers looked at the patients’ existing health conditions before the operation and found that those who had part of their kidney removed had lower rates of shortness of breath during exercise, chronic obstructive pulmonary disease (a type of lung disease), and long-term use of steroids.

The study also looked at complications after surgery and found no significant differences in the occurrence of minor or major complications between the two groups. However, a higher number of patients who had part of their kidney removed were readmitted to the hospital after surgery. Despite this, there were no significant differences in the rates of needing another surgery or in the number of deaths.

Overall, the study concludes that removing part of the kidney is a safe and doable operation for people aged 80-89 years old. However, it is crucial to provide thorough advice before surgery and carefully select suitable patients.

FAQs

  1. What types of kidney surgeries were analyzed in this research?
  2. Was there a difference in pre-existing health conditions between patients who had a full kidney removal and those who only had part of their kidney removed?
  3. Did the study find any difference in post-surgery complications or readmission rates between the two groups of patients?

Doctor’s Tip

A doctor might tell a patient about nephrectomy that it is important to discuss all potential risks and benefits of the surgery before proceeding. They may also advise the patient to maintain a healthy lifestyle, including staying active, managing their weight, and eating a balanced diet to help with recovery. Additionally, the doctor may recommend regular follow-up appointments to monitor kidney function and overall health post-surgery.

Suitable For

Patients who are typically recommended nephrectomy include those with kidney cancer, kidney stones, kidney infections, kidney trauma, or other kidney diseases that cannot be treated effectively with other methods. Additionally, patients with severe chronic kidney disease or kidney failure may also be recommended for nephrectomy to improve overall kidney function. Older patients, such as those in the study mentioned above, may also be considered for nephrectomy if they are otherwise healthy and able to tolerate the surgery. Ultimately, the decision to recommend nephrectomy for a patient will depend on their individual health status, the severity of their condition, and the potential benefits and risks of the procedure.

Timeline

Before nephrectomy:

  • Patient is diagnosed with a kidney condition such as cancer, kidney stones, or a non-functioning kidney
  • Patient undergoes pre-operative evaluations, including blood tests, imaging studies, and possibly a biopsy
  • Patient may be advised to stop certain medications or adjust their diet
  • Patient discusses the risks and benefits of surgery with their healthcare team
  • Surgery date is scheduled

After nephrectomy:

  • Patient undergoes the nephrectomy procedure, either partial or radical
  • Patient is monitored closely in the recovery room for any immediate complications
  • Patient may experience pain, fatigue, and discomfort in the days following surgery
  • Patient is discharged from the hospital once stable and able to manage at home
  • Patient follows up with their healthcare team for post-operative care, including monitoring for complications, wound care, and pain management
  • Patient may need to make lifestyle changes, such as avoiding heavy lifting or certain activities, and following a specific diet
  • Patient may require physical therapy or rehabilitation to regain strength and function
  • Patient undergoes follow-up imaging studies and appointments to monitor kidney function and overall health
  • Patient may need ongoing care or additional treatments depending on their specific condition and recovery process.

What to Ask Your Doctor

Some questions a patient should ask their doctor about nephrectomy include:

  1. What type of nephrectomy is recommended for my specific condition - partial or radical nephrectomy?
  2. What are the potential risks and complications associated with nephrectomy in my age group?
  3. How will the surgery impact my existing health conditions, such as shortness of breath during exercise or chronic obstructive pulmonary disease?
  4. What is the expected recovery time and post-operative care needed for this procedure?
  5. Are there any alternative treatments or less invasive options available for my condition?
  6. How often do patients in my age group need to be readmitted to the hospital after nephrectomy?
  7. What is the long-term outlook and potential impact on my quality of life after undergoing nephrectomy?
  8. Are there any specific pre-operative preparations or tests that I need to undergo before the surgery?
  9. How experienced is the surgical team in performing nephrectomy procedures on older adults?
  10. What is the success rate of nephrectomy in patients aged 80-89 years old based on your experience and research findings?

Reference

Authors: Jivanji D, Shpeen B, Kaplan-Marans E, Neckonoff E, Silver M, Schulman A. Journal: J Robot Surg. 2023 Aug;17(4):1867-1869. doi: 10.1007/s11701-023-01600-3. Epub 2023 Apr 17. PMID: 37067699