If you’ve been diagnosed with a kidney tumor, you need to know that some tumors or growths may be a cancer, and some may not. You should discuss and review imaging studies with your urologic oncologist to determine if the growth needs treatment. In some circumstances, the tumors may be followed, biopsied or treated.
Kidney Cancer Treatment Options
A surgery is performed through small, keyhole incisions to isolate the tumor away from other organs. Then fine needles are placed into the tumor. The needles are then cooled to below -100°C in the area of the tumor to kill the tumor cells. The tumor is usually frozen twice during the process and is monitored using ultrasound. The majority of the normal kidney is preserved. Typically, people recover rapidly from this procedure and have preservation of renal function.
Laparoscopic Robotic Partial Nephrectomy
Is a surgery using small incisions to remove the tumor and a small border of normal kidney. Depending upon the size and location of the tumor, it may not be necessary to remove the entire kidney. Some growths can be safely removed and leave behind most of the normal kidney. During this procedure, the blood vessels to the kidney are isolated. The blood vessels may or may not be clamped during the actual removal of the tumor to minimize blood loss. The time that the blood vessels are clamped is kept as short as possible. Advantages include removing the tumor, less pain, and preservation of kidney function.
Open Partial Nephrectomy
Some tumors are large or in a difficult location, but can be removed without removing the entire kidney. This is usually done through a 6 -7 inch incision on the side or on the abdomen. The kidney is cooled with ice to protect against injury to the kidney while the arteries are clamped. During the procedure, an ultrasound machine is used to allow the surgeon to precisely remove the tumor, while sparing as much of the kidney as possible.
Laparoscopic Radical Nephrectomy
If the entire kidney needs to be removed, a laparoscopic radical nephrectomy can be performed. The advantages of this procedure include smaller incisions, less blood loss, faster recovery period, and less use of pain medication.
Open Radical Nephrectomy
If a tumor is large or affecting other organs, a traditional open surgery may be required to safely remove all of the tumor and surrounding lymph nodes. It is important to identify key vascular structures throughout the procedure.
Some growths within the kidney are more closely related to bladder cancer. If this type of tumor is diagnosed, the kidney and the entire ureter will need to be removed. Additional lymph node tissue should be resected at the same time. The procedure can be performed laparoscopically or robotically to treat this aggressive form of cancer.
Non-cancer Kidney Treatment Options
Not all kidney surgeries are for growths or cancer. Some non-cancer kidney problems can be solved with surgery, such as obstruction of urine flow or large kidney stones.
If the connection between the ureter and the kidney does not develop properly, problems with urine drainage can occur. Sometimes this can happen with the formation of scar tissue or stricture from passing kidney stones. If this occurs, a section of the ureter can be removed and the ureter is reattached. This allows for normal drainage of urine. Often a temporary stent is used while the ureter is healing. The surgery can be performed laparoscopically or robotically.
If a kidney stone is larger than half-an-inch, it can be difficult to pass or remove it entirely. Using radiologic guidance, a small incision can be made through the back to the kidney stone. Then, telescopes and lasers can be used to break up and remove the large stone. Often a temporary stent or tube is left in place to help the kidney drain.