Traditionally, partial nephrectomy for renal cell carcinoma was performed only for tumors occurring in a solitary kidney or when the patient presented with bilateral disease.<sup>19 Goldstein A.E., Abeshouse B.S. Partial resections of the kidney: A report of 6 cases and a review of the literature. J Urol 1937 ;  38 : 15

Cliccare qui per andare alla sezione Riferimenti, 28 Marberger M., Pugh R.C., Auvert J. , e al. Conservative surgery of the renal carcinoma: The EIRSS experience. Br J Urol 1981 ;  53 : 528

Cliccare qui per andare alla sezione Riferimenti</sup> Because of the favorable results obtained in terms of patient survival, tumor control, and complication rates, the indications for nephron-sparing surgery were extended to include patients with small tumors and a normal contralateral kidney.<sup>20 Hafez K.S., Fergany A.F., Novick A.C. Nephron sparing surgery for localized renal cell carcinoma: Impact of tumor size on patient survival, tumor recurrence and TNM staging. J Urol 1999 ;  162 : 1930  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 26 Levy D.A., Slaton J.W., Swanson D.A. , e al. Stage specific guidelines for survival after radical nephrectomy for local renal cell carcinoma. J Urol 1998 ;  159 : 1163  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 27 Licht M.R., Novick A.C. Nephron sparing surgery for renal cell carcinoma. J Urol 1993 ;  149 : 1

Cliccare qui per andare alla sezione Riferimenti, 34 Kletscher B.A., Quian J., Bostwick D.G. , e al. Prospective analysis of multifocality in renal cell carcinoma: Influence of histological pattern, grade, number, size, volume and deoxyribonucleic ploidy. J Urol 1995 ;  153 : 904  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 39 Polascik T.J., Pound C.R., Meng M.V. , e al. Partial nephrectomy: Technique, complications and pathological findings. J Urol 1995 ;  154 : 1312  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 40 Provet T., Tessler A., Brown J. , e al. Partial nephrectomy for renal cell carcinoma: Indications, results and implications. J Urol 1991 ;  145 : 472

Cliccare qui per andare alla sezione Riferimenti, 55 Steinbach F., Stöckle M., Müller S.C. , e al. Conservative surgery of renal tumors in 140 patients: 21 years of experience. J Urol 1992 ;  148 : 24

Cliccare qui per andare alla sezione Riferimenti</sup> Small renal cell carcinomas are usually of lower stage and have a better prognosis. Owing to the widespread use of diagnostic ultrasound and CT, an increasing number of such lesions are detected incidentally,<sup>47 Rassweiler J., Merkle W.   Urologische Sonographie New York: Thieme Stuttgart (1997). 

Cliccare qui per andare alla sezione Riferimenti, 53 Ritchie A.W., de Kernion J.B. Incidental renal neoplasms: Incidence in Los Angeles County, treatment and prognosis. Prog Clin Biol Res 1988 ;  269 : 347

Cliccare qui per andare alla sezione Riferimenti</sup> and interest in nephron-sparing surgery and other organ-preserving approaches, such as cryotherapy<sup>37 Meraney A.M., Gill I.S., Sung G.T. , e al. Histology of renal tumors 3–6 months postcryoablation [abstract]. J Endourol 1999 ;  13 : A14

Cliccare qui per andare alla sezione Riferimenti</sup> or high-energy focused ultrasound,<sup>35 Köhrmann K.U., Michel M.S., Rassweiler J.J. , e al. Shock waves—focused ultrasound Smith's Textbook of Endourology. St. Louis: Quality Medical (1996).  661-679

Cliccare qui per andare alla sezione Riferimenti</sup> can be expected to grow.

Clayman and colleagues<sup>13 Clayman R.V., Kavoussi L.R., Soper N.J. , e al. Laparoscopic nephrectomy: Initial case report. J Urol 1991 ;  146 : 278

Cliccare qui per andare alla sezione Riferimenti</sup> pioneered laparoscopic nephrectomy when they removed a renal oncocytoma in 1990. Almost 1 year, later Coptcoat and co-workers<sup>14 Coptcoat MJ, Rassweiler J, Wickham JEA, et al: La-paroscopic nephrectomy for renal cell carcinoma [abstract no. D-66). I n Proceedings of the Third Interna- tional Congress for Minimal Invasive Therapy, Boston, November 10-12, 1991

Cliccare qui per andare alla sezione Riferimenti</sup> used the same technique for radical extirpation of a T2 renal cell carcinoma. Despite the enthusiasm of these pioneering surgeons, laparoscopic surgery, especially laparoscopic nephrectomy, has not become a widespread procedure. Expertise has concentrated in centers that are increasingly becoming active throughout the world.<sup>4 Barrett P.H., Fentie D.D., Taranger L. Laparoscopic radical nephrectomy with morcellation [abstract] J Endourol 1997 ;  11 (S128) : 6

Cliccare qui per andare alla sezione Riferimenti, 5 Cadeddu J.A., Ono Y., Clayman R.V. , e al. Laparoscopic nephrectomy for renal cell cancer: Evaluation of efficacy and safety. A multi-center experience Urology 1998 ;  52 : 773  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 15 Coptcoat M.J., Joyce A., Rassweiler J. , e al. Laparoscopic nephrectomy: The Kings and Mannheim clinical experience [abstract]. J Urol 1992 ;  147 : 433 A

Cliccare qui per andare alla sezione Riferimenti, 18 Gill I.S., Soble J., Gyung T.S. , e al. Retroperitoneoscopic radical nephrectomy in 41 patients: Expanding indications and impact of specimen size [abstract]. J Endourol 1998 ;  12 : S103

Cliccare qui per andare alla sezione Riferimenti, 29 McDougall E.M., Clayman R.V., Elashry O.M. Laparoscopic radical nephrectomy for renal tumor: The Washington University experience. J Urol 1996 ;  155 : 1180  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 41 Ono Y., Sahashi M., Yamada S. , e al. Laparoscopic nephrectomy without morcellation for renal cell carcinoma: Report of initial 2 cases. J Urol 1993 ;  150 : 1222

Cliccare qui per andare alla sezione Riferimenti, 45 Rassweiler J.J., Henkel T.O., Potempa D.M. , e al. The technique of transperitoneal laparoscopic nephrectomy, adrenalectomy and nephroureterectomy Eur Urol 1993 ;  22 : 425

Cliccare qui per andare alla sezione Riferimenti, 46 Rassweiler J., Coptcoat M.J. Laparoscopic surgery of the kidney and adrenal gland Laparoscopic Surgery in Urology. New York: Thieme Stuttgart (1996).  139-155

Cliccare qui per andare alla sezione Riferimenti, 57 Tschada R.K., Rassweiler J.J., Schmeller N. , e al. Laparoscopic radical nephrectomy—the German experience [abstract]. J Urol 1995 ;  153 : 479A

Cliccare qui per andare alla sezione Riferimenti</sup> Nevertheless, even among laparoscopic surgeons, the indications for radical nephrectomy are still under debate. Only 37 of 482 nephrectomies reported in a recently published German multicenter study were performed for renal malignancy.<sup>49 Rassweiler J., Fornara P., Weber M. , e al. Laparoscopic nephrectomy: The experience of the laparoscopic working group of the German Urological Association. J Urol 1998 ;  160 : 18  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> During the last 3 years, there has been an increasing number of reports of laparoscopic radical nephrectomy using different technical approaches, such as transperitoneal laparoscopy,<sup>42 Ono Y., Kinukawa T., Hattori R. , e al. Long-term result of laparoscopic radical nephrectomy [abstract]. J Endourol 1998 ;  12 : S103

Cliccare qui per andare alla sezione Riferimenti, 55 Steinbach F., Stöckle M., Müller S.C. , e al. Conservative surgery of renal tumors in 140 patients: 21 years of experience. J Urol 1992 ;  148 : 24

Cliccare qui per andare alla sezione Riferimenti</sup> retroperitoneoscopy,<sup>12 Cicco A., Joual A., Hoznek A. , e al. Radical nephrectomy by retroperitoneal laparoscopic approach versus open surgery [abstract]. J Urol 1998 ;  159 : 154 A

Cliccare qui per andare alla sezione Riferimenti, 52 Rassweiler J., Coptcoat M., Frede T. Laparoscopic radical nephrectomy and nephroureterectomy for treatment of renal cell and transitional cell carcinoma: Current status. Urol Integr Invest 1999 ;  4 : 225

Cliccare qui per andare alla sezione Riferimenti</sup> and hand-assisted and gasless laparoscopy.<sup>59 Wolf S., Moon T.D., Madisom W.I. , e al. Hand-assisted laparoscopic nephrectomy: Comparison to standard laparoscopic nephrectomy. J Urol 1998 ;  160 : 22  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup>

Based on their favorable experience with laparoscopic radical nephrectomy and with partial nephrectomy for benign renal disorders,<sup>21 Hoznek A., Salomon L., Antipon P. , e al. Partial nephrectomy with retroperitoneal laparoscopy. J Urol 1999 ;  162 : 1922  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 23 Janetschek G., Seibold J., Radmayr C. , e al. Laparoscopic heminephrectoureterctomy in pediatric patients. J Urol 1997 ;  158 : 1928  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 24 Janetschek G., Daffner P., Peschel R. , e al. Laparoscopic nephron sparing surgery for small renal cell carcinoma. J Urol 1998 ;  159 : 1152  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 51 Rassweiler J.J., Seemann O., Frede T. , e al. Retroperitoneoscopy: Experience with 200 cases. J Urol 1998 ;  160 : 1265  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> the authors now perform nephron-sparing surgery for small renal cell carcinoma as an alternative to the open technique.