Partial nephrectomy of renal cell carcinoma: Principles and controversies

Whenever preservation of functioning renal parenchyma is important nephron- sparing surgery should be substituted for radical nephrectomy. The first pa rtial nephrectomy was performed in 1884 by Wells for the removal of a perir enal fibrolipoma. Partial nephrectomy because of renal malignancy was first described in 1890 by Czerny. Today partial nephrectomy has become a standa rd procedure and provides effective therapy for appropriately selected pati ents with renal cell carcinoma. However, its future importance and value as a therapeutic option for the control of localized kidney tumor depends on the use of the correct diagnostic inventory to obtain an accurate indicatio n and proper patient selection. Moreover, explicit attention has to be draw n to the surgical skills required to perform this complex operation and to prevent postoperative complications and control tumor recurrence.