[Minimally invasive techniques in localized renal tumours less than 40 mm in diameter in adults: technical aspects...

Partial nephrectomy has recently become the reference treatment for localized renal cancer, less than 40 mm in diameter, in adults. The development of laparoscopy remains limited by the difficulties of haemostasis in these indications. "Minimally invasive techniques" have therefore been developed in this context, in order to achieve two objectives: parenchyma sparing and low morbidity. Various approaches, using cryotherapy, radiofrequency, microwaves or high intensity focused ultrasound, are under investigation. The preliminary clinical results appear to be promising, but the efficacy endpoints of these treatments still need to be evaluated, as well as the survival results based on longer term follow-up. However, if the good initial results are confirmed, these techniques could constitute, in the future, an alternative to surgery for the management of renal cancers less than 40 mm in diameter The objective of this article is to review these various techniques, to summarize the studies published in the literature and to discuss the preliminary oncological results.