Nephrectomy - Revision history

Dominicmangino at 23:17, 25 September 2025

2025-09-25T23:17:45Z

← Older revision		Revision as of 16:17, 25 September 2025
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	\|-		\|-
	\|Cardiovascular		\|Cardiovascular
	\|Renal hypertension		\|Renal hypertension, assess for IVC thrombus,
	\|-		\|-
	\|Pulmonary		\|Pulmonary
	\|		\|Possible pulmonary mets if RCC
	\|-		\|-
	\|Gastrointestinal		\|Gastrointestinal
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	\|-		\|-
	\|Renal		\|Renal
	\|		\|often CKD present
	\|-		\|-
	\|Endocrine		\|Endocrine
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	===Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. -->===		===Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. -->===
	Electrolytes, BUN, Cr. If indicated, perform additional workup for cardiac and pulmonary disease.		Electrolytes, BUN, Cr. If indicated, perform additional workup for cardiac and pulmonary disease

	===Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. -->===		===Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. -->===
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	* Standard monitoring		* Standard monitoring
			*2 large bore IVs
	* Arterial line		* Arterial line
	* Consider central line if IVC or RA thrombus		* Consider central line if IVC or RA thrombus
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	\|+		\|+
	!		!
	!~~Variant 1~~		!Simple
	!~~Variant 2~~		!Open Radical
	\|-		\|-
	\|Unique considerations		\|Unique considerations
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	\|-		\|-
	\|Position		\|Position
	\|		\|Flank or prone
	\|		\|Flank vs prone
	\|-		\|-
	\|Surgical time		\|Surgical time
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	\|-		\|-
	\|EBL		\|EBL
	\|		\|500
	\|		\|500
	\|-		\|-
	\|Postoperative disposition		\|Postoperative disposition

Oliviamsutton: started, infobox + basics

2022-04-05T00:41:56Z

started, infobox + basics

← Older revision		Revision as of 17:41, 4 April 2022
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	{{Infobox surgical procedure		{{Infobox surgical procedure
	\| anesthesia_type =		\| anesthesia_type = General
	\| airway =		\| airway = ETT
	\| lines_access =		\| lines_access = Two large bore PIV, usually with a-line
	\| monitors =		\| monitors = Standard, +/- A-line
	\| considerations_preoperative =		\| considerations_preoperative = 2u pRBC on standby, usually EKG, CBC, CMP
	\| considerations_intraoperative =		\| considerations_intraoperative = Avoid nitrous (bowel expansion), avoid extremities with AV fistula, and avoid forearm veins for patients who may need future dialysis, avoid potassium containing fluids in patients with impaired renal function
	\| considerations_postoperative =		\| considerations_postoperative = hemorrhage, urinary fistula, UTI, DVT, wound infection, pleural effusion
	}}		}}

Chris.Rishel: Text replacement - "|Respiratory" to "|Pulmonary"

2022-02-22T05:46:07Z

Text replacement - "|Respiratory" to "|Pulmonary"

← Older revision		Revision as of 22:46, 21 February 2022
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	\|Renal hypertension		\|Renal hypertension
	\|-		\|-
	\|~~Respiratory~~		\|Pulmonary
	\|		\|
	\|-		\|-

Josh Calvano: Described surgical nephrectomy categories and reason for surgery. Will continue to build out anesthetic considerations.

2022-02-02T23:30:28Z

Described surgical nephrectomy categories and reason for surgery. Will continue to build out anesthetic considerations.

← Older revision		Revision as of 16:30, 2 February 2022
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	}}		}}

	~~Provide a brief summary~~ of ~~this~~ surgical ~~procedure~~ and ~~its indications here~~.		There are three categories for nephrectomies, depending on the extent of surgical involvement, these include: simple, partial, and radical nephrectomy.

	== ~~Preoperative management~~ ==		A '''simple nephrectomy''' refers to the surgical removal of the affected kidney and small segment of the proximal ureter. Diagnoses warranting this procedure can include benign conditions, such as: hematuria, recurrent urinary tract infections, nephrolithiasis, hydronephrosis, flank pain, or kidney donation<ref>{{Cite web\|title=Nephrectomy\|url=https://www.nephrologyspecialistsoftulsa.com/nephrectomy.php\|access-date=2022-02-02\|website=www.nephrologyspecialistsoftulsa.com}}</ref><ref>{{Cite web\|title=Simple Nephrectomy\|url=http://urology-textbook.com/simple-nephrectomy.html\|access-date=2022-02-02\|website=urology-textbook.com}}</ref>.

	=== Patient evaluation<!-- Describe the unique and important aspects of preoperative evaluation. Add or remove rows from the systems table as needed. --> ===		A '''partial nephrectomy''' refers to the surgical removal of the pathologic portion of the kidney. Diagnoses warranting this procedure can include: chronic hydronephrosis, hypoplastic kidney, renovascular hypertension, or a double collecting system<ref name=":0">{{Cite book\|url=https://www.worldcat.org/oclc/1117874404\|title=Anesthesiologist's manual of surgical procedures\|date=2020\|others=Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu\|isbn=978-1-4698-2916-6\|edition=Sixth edition\|location=Philadelphia\|oclc=1117874404}}</ref>.

			A '''radical nephrectomy''' refers to the surgical removal of the affected kidney, with surrounding perinephric fat, Gerota's fascia, proximal 2/3 of the ureter, and can additionally include paracaval or para-aortic lymphadenectomy<ref name=":0" />. Diagnoses warranting this procedure are usually renal cell carcinoma or a double collecting system. Of note, if there is tumor or thrombus involving the vena cava or right atrium an interprofessional team involving cardiac surgery may also be involved.

			== Preoperative management==

			=== Patient evaluation<!-- Describe the unique and important aspects of preoperative evaluation. Add or remove rows from the systems table as needed. -->===
	{\| class="wikitable"		{\| class="wikitable"
	\|+		\|+
	!System		!System
	!Considerations		! Considerations
	\|-		\|-
	\|Neurologic		\|Neurologic
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	\|-		\|-
	\|Cardiovascular		\|Cardiovascular
	\|		\|Renal hypertension
	\|-		\|-
	\|Respiratory		\|Respiratory
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	\|}		\|}

	=== Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. --> ===		===Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. -->===
			Electrolytes, BUN, Cr. If indicated, perform additional workup for cardiac and pulmonary disease.

			===Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. -->===

			===Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. -->===

	=== ~~Operating room setup~~<!-- Describe any ~~unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate~~. If none, this section may be removed. --> ===		===Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. -->===

	==~~= Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> =~~==		==Intraoperative management ==

	=== ~~Regional~~ and ~~neuraxial techniques~~<!-- ~~Describe any potential regional~~ and/or ~~neuraxial techniques which may be used~~ for this case. ~~If none, this section may be removed~~. --> ===		===Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. -->===

	~~== Intraoperative management ==~~		* Standard monitoring
			* Arterial line
			* Consider central line if IVC or RA thrombus

	=== ~~Monitoring~~ and ~~access~~<!-- ~~List~~ and~~/or describe monitors~~ and ~~access~~ typically ~~needed~~ for this case~~. Please describe rationale for any special monitors or access~~. --> ===		===Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. -->===

	~~=== Induction and airway management<!-- Describe the important considerations and general approach to the~~ induction ~~of anesthesia and how the airway is typically managed for this case. --> ===~~		* Standard induction

	=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===		===Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->===

	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		===Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. -->===

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		===Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->===

	== Postoperative management ==		==Postoperative management==

	=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===		===Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. -->===

	=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===		===Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. -->===

	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		===Potential complications<!-- List and/or describe any potential postoperative complications for this case. -->===

	== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==		==Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). -->==

	{\| class="wikitable wikitable-horizontal-scroll"		{\| class="wikitable wikitable-horizontal-scroll"
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	\|}		\|}

	== References ==		==References==

	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]
			<references />

Oliviamsutton: Created page with "{{Infobox surgical procedure | anesthesia_type = | airway = | lines_access = | monitors = | considerations_preoperative = | considerations_intraoperative = | considerati..."

2022-01-24T20:11:12Z

Created page with "{{Infobox surgical procedure | anesthesia_type = | airway = | lines_access = | monitors = | considerations_preoperative = | considerations_intraoperative = | considerati..."

New page

{{Infobox surgical procedure
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

Provide a brief summary of this surgical procedure and its indications here.

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Respiratory
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

=== Positioning ===

=== Maintenance and surgical considerations ===

=== Emergence ===

== Postoperative management ==

=== Disposition ===

=== Pain management ===

=== Potential complications ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]