Extracorporeal partial nephrectomy during pharmaco-cold ischemia in patients with renal cell carcinoma: history and current problems

Objective: Due to the increase in the number of patients suffering from chronic kidney diseases who need renal replacement therapy (RRT), as well as those on the waiting list for kidney transplantation, the relevance of common recommendations development for nephron-sparing treatment is beyond doubt. Material: Despite the gradual accumulation of experience in the field of nephron-sparing surgery (NSS) and improvement of surgical technique, there are still many unsolved problems. For example, the question of the tactics of surgical treatment for patients with kidney cancer is debatable. Results: The endeavour to avoid the renoprive state, that is inevitable after nephrectomy, is due to a significant decrease in the quality of life of patients on chronic hemodialysis. Moreover, RRT remains a significant cause of other diseases and mortality from them. However, the treatment of malignant tumours, including kidney cancer, should be radical. Can NSS always be radical? Conclusion: Development of indications and contraindications, as well as the improvement of surgical technique are topical problems of modern NSS.