ReviewOpen partial nephrectomy in renal cell cancer - Essential or obsolete?

- Partial nephrectomy is the gold standard treatment for T1a/b renal tumours.
- Open partial nephrectomy retains a valuable role in treating complex tumours.
- It allows the use of cold ischaemia when prolonged ischaemic times are anticipated.
- Technological advances have allowed us to push boundaries in partial nephrectomy.

Since the first partial nephrectomy was first conducted 131 years ago, the procedure has evolved into the gold standard treatment for small renal masses. Over the past decade, with the introduction of minimally invasive surgery, open partial nephrectomy still retains a valuable role in the treatment of complex tumours in challenging clinical situations (e.g. hereditary renal cancer or single kidneys), and enables surgeons to push the boundaries of nephron-sparing surgery. In this article, we consider the origin of the procedure and how it has evolved over the past century, the surgical techniques involved, and the oncological and functional outcomes.