Radical nephrectomy for nephron-sparing nephron is not a panacea

Compared with traditional radical renal cancer surgery, successful nephron-sparing surgery has the same tumor control effect and the advantage of preserving more functional nephrons, so it has become a hot topic in renal cancer surgery research. However, this surgery requires high technical content and has very strict surgical indications. Not every renal cancer patient can preserve their kidneys.

It is generally believed that only tumors with a diameter of less than 4 cm and confined to the edge or upper and lower levels of the kidney are worth preserving the kidney. At the same time, there are many patients with solitary kidney renal cancer, bilateral kidney renal cancer, unilateral renal cancer with severe renal insufficiency, and unilateral renal cancer with pre-existing renal disease in the contralateral kidney. For them, nephrectomy with nephron preservation is the best choice. These patients undergo kidney-preserving surgery, which can not only achieve the goal of completely removing the tumor lesions like traditional radical nephrectomy, but also preserve normal renal parenchymal units to the maximum extent, providing a guarantee for the patient's kidney function reserve and adding a guarantee for their future health.

However, for patients with kidney cancer whose tumors are large and close to the center, it is not worth the risk of residual tumor after surgery in order to preserve the kidney. It is absolutely unacceptable. The goal of tumor surgery is to remove as much cancerous tissue as possible. Therefore, radical nephrectomy that preserves the kidney unit is not a universal surgery. Whether to preserve the kidney after kidney cancer must be carefully decided by experienced surgeons based on various factors.