The role of nephron-sparing surgery for renal cell carcinoma is well established in patients where preservation of nephron is essential. Localized RCC remains a surgical disease, with excision of the tumor or tumor-bearing kidney offering the only chance of cure for affected patients.

After the wide spread acceptance of partial nephrectomy (NSS) as equivalent treatment to radical nephrectomy in appropriately selected cases of RCC, a range of nephron-sparing procedure has become available to patients in Bangladesh. These include laparoscopic approach, ablative technologies as well as open partial nephrectomy. This presentation aims to clarify the current status of these nephron sparing techniques from the experience of managing 566 cases in 24 years including 12 solitary kidneys focusing on selection criteria, tumor size, outcome & complications.

Studies show that partial nephrectomy yields comparable cancer- specific survival rates to radical nephrectomy for localized RCC. Cancer -specific survival rates after partial nephrectomy can range from 84% to 93%. Local recurrence within the operated kidney is rare occurring in less than 5% of patients. For tumors 4 cm or less local recurrence rates are even lower, at 0% to 3%.

Partial Nephrectomy is safe and surerior to readical nephrectomy in presseving renal function and preventing chronic kidney disease. A functioning renal remnant of at least of 20% of normal renal parenchyma seems to be necessary to avoid end – stage renal failure in these patients.