Glossary of Terms for the Nephrectomy Audit
To assist patients in understanding the terms used, BAUS has produced a short guide, in alphabetical order below. In addition, patients are encouraged to use the relevant patient information on our website and to click on the links within the glossary for further details.
|
|
Complications |
The incidence of complications can vary from very minor (which do not alter the length of stay in hospital) to serious (which may require further intervention). It was decided to record all complications labelled “Clavien 3” and above – i.e. any complication requiring surgical, endoscopic or radiological intervention, which would prolong hospital stay. |
|
|
Length of Stay |
T his is the number of nights that a patient stays in hospital following their procedure. There are a number of factors that alter an individual’s length of stay, including the complexity of surgery, the patient’s overall health, and the level of support at home once discharged. The actual length of stay can be compared with the expected length of stay, extracted from Hospital Episode Statistics. |
|
|
Nephrectomy |
This involves removal of the kidney, for benign or malignant disease, either through a conventional open incision or through several keyhole incisions (laparoscopic). The latter requires the placement of a telescope and operating instruments into your abdominal cavity using 4-5 small incisions; one incision will need to be enlarged to allow removal of the kidney (pictured). |
|
|
Nephro-Ureterectomy |
This involves removal of the kidney (and surrounding fat) for suspected cancer of the kidney, together with the whole ureter (the tube that carries urine from the kidney to the bladder). The procedure can be undertaken either by an open or laparoscopic approach (pictured). |
Partial Nephrectomy |
This involves removal of part of the kidney with the surrounding fat (pictured) for suspected cancer of the kidney, either through an open approach or through several keyhole incisions (laparoscopic). This involves the placement of a telescope and operating instruments into your abdominal cavity using 3-5 small incisions. This operation is typically carried out for patients with small, T1 tumours. |
|
|
Stage of Tumour |
Kidney tumours are categorised by their size and degree of spread to surrounding structures, by the use of a T (Tumour) Stage, ranging from 1 to 4. Most tumours are stage T1, the earliest stage. Before treatment, this is called "Clinical T Stage". After surgery, the stage can be better defined once the kidney has been carefully examined. This is called "Pathological T Stage".
Operations for larger and more advanced tumours (those with a higher T stage) are associated with higher risks of bleeding, and frequently are done by traditional open surgery. Surgeons performing surgery for higher stage tumours may appear to have worse outcomes in terms of transfusion rates, length of stay and complications; nonetheless, they and their team are among the most skilful due to the complexity of the surgery.
|
|
|
Transfusion Rate |
This is the proportion of patients (expressed as a percentage) requiring a blood transfusion following surgery, and is often related to the complexity of the procedure and, separately, to the underlying health of the patient. |