In this study, we retrospectively reviewed data analysing perioperative and postoperative outcomes in patients with a large renal mass >70mm. Trifecta and “Optimal outcome” were defined, and rates of achieving each were evaluated in patients undergoing either Robotic partial nephrectomy (RPN) or Laparoscopic partial nephrectomy (LPN).

In total, 10 patients underwent partial nephrectomy by a single surgeon from 2019 to 2024. Trifecta was defined by three components: Warm Ischemia time (WIT)<25min, Zero postoperative copmplications, Negative surgical margin. Optimal outcome was defined as achieving trifecta and short-term (3 months) eGFR preservation of more than 90%. Postoperative complications were classified using the Clavien-Dindo system. Statistical analysis was carried out using GraphPad Prism V10.4.

10 patients met the inclusion criteria for this case series. The mean age was 61.70, and the average tumour size was 87.10mm. The mean warm ischemia time was 15.25 mins, and the median renal score was 11. Negative surgical margins were achieved in 88.89% of cases, no postoperative complications were recorded, and eGFR preservation >90% was achieved in 80% of the patients. The defined trifecta was met in 60% of cases while optimal outcome was achieved in 50%.

In this single surgeon case series, partial nephrectomy showed favourable outcomes in terms of perioperative and postoperative stats.. Achievement of trifecta and “optimal outcome” supports its feasibility and safety as a surgical management option for large complex renal masses.. However, due to the limited number of cases, further controlled studies are warranted to confirm its broader applicability.