Post-Surgery Complications From Kidney Surgery
Surgery on the kidney is done for many reasons, such as transplants, removal of the kidney (nephrectomy) and on the adrenal glands situated on the kidney. Surgery always has risks of complications due to its invasive nature, and the kidney offers unique sets of complications after the operation.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Mortality
Usually, patients have a very minimal risk of death when undergoing kidney surgery. However, those with atherosclerotic disease of the renal arteries have a much higher chance of death. Screening of the patients preoperatively is done to identify those with increased risk and preoperative treatment to reduce surgical risk.
Hypertension
Complications of Aortic Aneurysm Surgery
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High blood pressure, or hypertension, often occurs in patients after kidney surgery. It can be due to a variety of reasons, such as kidney damage and poorly controlled pain. If not properly controlled, it can cause bleeding from fresh surgical sutures.
Hemorrhage
Increased bleeding after surgery can occur in almost all surgical procedures, and its occurrence in kidney surgery is usually due to poor technique. It can appear early after surgery, and also weeks to months later. In the latter case, it can be attributed to infection of sutures or prosthetic grafts eroding into organs.
Renal Artery Thrombosis
The Side Effects of Kidney Removal
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This refers to clots that can form and obstruct the renal artery. It generally occurs within the first few days after surgery. Decreased blood flow after surgery, decreased blood volume and the patient being predisposed to clots are risk factors for development of this complication.
Stenosis of the Renal Artery
This is typically a late complication that can occur from weeks to years after surgery. Risk factors for this are similar to renal artery thrombosis. This complication describes when the lumen of the artery is narrowed, which decreases blood flow through the artery.
Renal Artery Aneurysm
This complication refers to the development of an area of weakness in the renal artery after surgery that pouches out and is at risk of rupture. This usually develops when arterial graft tissue is used during surgery that's not strong enough to handle the blood pressures that normally flow through blood vessels.
Aortic Complications
During renal surgery, the abdominal aorta can be clamped and then unclamped to make surgery possible in that area without excessive bleeding. This can cause tears in the aorta, in addition to dislodging cholesterol plaques that can travel elsewhere in the body to cause damage--such as in the brain or to the kidney itself.
Kidney Failure
This complication is usually a result of decreased blood to the kidney during surgery. This manifests as decreased urine production. The best way to prevent it is good technique during surgery to ensure the kidney doesn't go long periods without adequate blood flow.
Bowel Injury
This is most common during laparoscopic kidney surgery because of the decreased visual field that a surgeon has when using a camera to view the surgery 2. Injuries can occur out of the view of the surgeon and manifest as persistent pain with subsequent abdominal symptoms such as diarrhea, nausea and persistent bowel sounds. It can progress to seriously threaten the patient’s life, so the surgeon must be vigilant after laparoscopic procedures 2.
Blood Vessel Injury
This can also occur in laparoscopic surgeries, due to the same problems with visualization that result in bowel injury. Many important blood vessels in the area can be damaged during surgery that can elude the surgeons view, so vigilance is crucial.
Related Articles
References
- “Campbell-Walsh Urology, 9th Edition;” Wein; 2007
- Urology. “Complications of Transperitoneal Laparoscopic Nephrectomy: A Single-center Experience.” Kim B, Yoo E, Kwon T. Volume 73, Issue 6 (June 2009)
- “Sabiston Textbook of Surgery, 18th Edition;” Townsend; 2007
- Solodova RF, Galatenko VV, Nakashidze ER, et al. Instrumental mechanoreceptoric palpation in gastrointestinal surgery. Minim Invasive Surg. 2017;2017:6481856. doi:10.1155/2017/6481856
- O'Connor SC, Mallard M, Desai SS, et al. Robotic Versus Laparoscopic Approach to Hiatal Hernia Repair: Results After 7 Years of Robotic Experience [published online ahead of print, 2020 Aug 18]. Am Surg. 2020;3134820943547. doi:10.1177/0003134820943547
- Liu Z, Tang S, Tian X, et al. Laparoscopic conversion to open surgery in radical nephrectomy and tumor thrombectomy: causal analysis, clinical characteristics, and treatment strategies. BMC Surg. 2020;20(1):185. Published 2020 Aug 13. doi:10.1186/s12893-020-00845-1
- Buia A, Stockhausen F, Hanisch E. Laparoscopic surgery: A qualified systematic review. World J Methodol. 2015;5(4):238-54. doi:10.5662/wjm.v5.i4.238
- Zhang W, Che X. Feasibility and Safety of Laparoscopic Treatment for Early and T3 Stage Gallbladder Cancer: A Systematic Review [published online ahead of print, 2020 Aug 17]. Surg Laparosc Endosc Percutan Tech. 2020;10.1097/SLE.0000000000000852. doi:10.1097/SLE.0000000000000852
- Fu SQ, Wang SY, Chen Q, Liu YT, Li ZL, Sun T. Laparoscopic versus open surgery for pheochromocytoma: a meta-analysis. BMC Surg. 2020;20(1):167. Published 2020 Jul 25. doi:10.1186/s12893-020-00824-6
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Writer Bio
Saad Mohammad, M.D., is currently in the process of applying to residency anesthesiology. His first published research occurred in 2009 at the American Thoracic Society National Conference where a poster presentation was accepted and at the Bridgeport Symposium 2009. He began professionally writing in 2009 for Demand Studios as a freelance writer on issues in health and medicine.