Partial Nephrectomy for Renal CancerA Phoenix Risen from the Ashes: A Case Series on Totally Laparoscopic Partial Nephrectomy with Review of Literature

Abstract

Partial nephrectomy, also called Kidney-sparing Surgery (KSS) or Nephron-sparing Surgery (NSS), is an operation wherein, only a cancerous renal tumour or diseased renal tissue is surgically removed; leaving behind as much healthy renal tissue as possible. Understandably, it was initially preferred in patients with solitary kidney and those, with concurrent bilateral tumours. Over the first two decades of the 21st century, Partial Nephrectomy (PN) has become the standard procedure for many renal tumours; even in unilateral disease. This is because of early pick up due to significant developments in imaging modalities and also, due to better understanding of the biology of renal tumours. With advances in minimal access surgery, partial nephrectomy too has come under its ambit. In the present case series, it's fascinating journey has been discussed- its exciting rise, subsequent downfall and then its unique rise again; as the preferred surgical therapy for many renal tumours, around the world. The purpose of reporting the present case series on Laparoscopic Partial Nephrectomy (LPN) performed for renal cancer, was to share the authors’ early experience and results on the topic and to compare them with the world literature. Also, the aim was to underscore the fact that, in an advanced laparoscopy set up, with optimum patient selection and availability of advanced laparoscopic skills, it is an effective and feasible operation. Herein, the authors have described three cases of totally LPN and review of literature on the same. Over an average follow-up period of 23 months, all three patients continue to be asymptomatic and disease free.

Keywords

• laparoscopy
• nephron-sparing
• renal carcinoma