Peter Weibl
The aim is to present the current concept of zero ischemia partial nephrectomy in the treatment of predominantly endophytic renal tumours. Not long time ago, the duration of ischemia has been considered as the key aspect of partial nephrectomy. According to the recent literature data, the calculated percentage/volume of the renal remnant is an important risk factor in developing of chronic kidney disease. The ischemia time is a modifiable parameter; however on the other hand, the amount of residual healthy renal parenchyma strongly depends on the tumour size and location. At present, for cT1 tumours, partial nephrectomy has fully supplanted radical nephrectomy as the reference standard treatment, given the superior functional, and equivalent oncological outcomes. The concept of zero-ischemia partial nephrectomy was initially established on solitary kidney tumours. However, current trends broad the horizons of the partial nephrectomy indications for patients with healthy contralateral kidney. Although at the cost of larger blood loss, but with comparable oncological control, the risk of chronic kidney disease developing is lowered.