The kidney is richly vascularized and has brittle tissue. Pseudoaneurysms and arteriovenous fistulas may form at the vascular dissection of the renal surgical wound, leading to postoperative renal hematoma or hematuria, which in severe cases require interventional selective embolization of the renal artery and in a few cases even surgical removal of the kidney.
When the tumor is close to a major renal artery or branch, the postoperative renal arterial blood supply is vulnerable, and in a few patients, this may cause local or global atrophy of the remaining kidney, with diminished or lost function. When the tumor invades or is close to the renal pelvis and calyces, there is also the possibility of postoperative leakage, requiring reoperation if there is prolonged failure to heal.
Partial nephrectomy (also known as renal unit preservation surgery) mostly requires blocking the main or branch renal arteries, and prolonged blocking may affect the recovery of renal function after surgery.
Postoperative considerations
Patients generally need to rest in bed after partial nephrectomy with minimal lumbar activity, mainly to prevent bleeding from the renal wound that was sutured during surgery, but they can be turned appropriately with the assistance of nurses and family members to encourage more movement of the extremities.
Because patients with partial nephrectomy are bedridden for a long time, their intestinal peristalsis is slow and they are prone to abdominal distension, so they need to be given appropriate medications to strengthen intestinal peristalsis and laxatives to keep their stools as smooth as possible. In the later stage, foods with high protein, high calories and high vitamins are encouraged, while stimulating foods, especially chili peppers, are avoided. Eat a meat-and-vegetable diet with plenty of vegetables and fruits to keep the bowels open and avoid constipation. Quit smoking and drink as little alcohol as possible.
Exercise and exercise after surgery should pay attention to both protecting the incision to prevent it from splitting and forming an incisional hernia and avoiding secondary bleeding from the kidneys due to strenuous exercise, therefore:
- For 1 month, we should be as inactive as possible and can take moderate walks to prevent falls.
- No heavy physical labor for 3 months, no strenuous exercise, including running, playing ball, swimming, etc., no forceful side-bending of the waist from side to side, and no lifting of heavy objects.
- After 3 months, appropriate outdoor activities and light physical exercise can enhance physical fitness, but avoid overexertion and cold and flu.