Partial nephrectomy for renal tumors

Long-term oncological and functional outcome is important in the treatment of small renal tumors. Since a decrease in renal function can lead to an increase in the risk of cardiovascular events and patient death due to the development of chronic kidney disease, we need to select a suitable treatment that includes active surveillance, ablation therapy and partial nephrectomy for nephron sparing. Recent reports have shown the efficacy of robot-assisted partial nephrectomy (RAPN) compared with open and laparoscopic surgery for difficult cases such as hilar, endophytic or large tumors. Although the indication of RAPN for renal tumors has expanded, there are some cases where we have to decide to perform radical nephrectomy for oncological safety. Furthermore, some reports have suggested that one of the factors for trifecta achievement, which was defined as negative surgical margins, freedom from perioperative complications, and an short ischemia time, is the experience of the surgeon who will carry out the procedure. We need to decide on the treatment after carefully judging the adequacy of its indication and to comprehend the prophylaxes and coping strategies so as to prevent severe complications.