Surgical Treatment of Localised Renal Cancer

The management of localised renal cancer has been revolutionised with the introduction of laparoscopy and minimally invasive techniques, achieving comparable oncologic results and reduced morbidity. With the detection rate of small renal lesions increasing, the diagnostic approach and surgical treatment shift to nephron-sparing surgery and less invasive techniques. Today, open partial nephrectomy (OPN), laparoscopic partial nephrectomy (LPN), radiofrequency ablation, and cryotherapy are treatment options. Comparing OPN and LPN, multicentre studies have shown equivalent cancer-specific survival rates. Robot-assisted partial nephrectomy seems to have an advantage with regard to decreased ischemia time compared to conventional laparoscopy. OPN and LPN are now preferred treatment options for the surgical treatment of smaller renal lesions (<7 cm). With increasing experience in minimally invasive techniques, the laparoscopic and robotic approaches are becoming the preferred techniques in specialised centres. Promising novel augmented reality tracking systems may further improve the surgical and oncologic outcome of laparoscopic and robotic procedures. (C) 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.