To explore the possibility of partial nephrectomy in the treatment of renal cancer with renal vein tumor thrombus.

From January 2018 to December 2021, laparoscopic partial nephrectomy was carried out in Shanghai Changhai Hospital for renal malignant tumors. Six of these patients had renal cell carcinoma with renal vein tumor thrombus. Four were males and 2 were females. Three tumors located in the left kidney and 3 in the right kidney.

The tumor was 1.8-3.5 cm in diameter. Five patients were successful in sparing the kidney. In one case, the renal vein was full of thrombus and the distance from the tumor to thrombus was far away. Therefore, the surgery was converted to radical nephrectomy. In one patient with solitary kidney, iced water was applied during surgery. The operation time was 129-195 min, the warm ischemia time was 24-32 min, and the intraoperative bleeding volume was 100-200 ml. No positive margin was detected in the patients with successfully kidney sparing. One patient had mild hematuria after operation, and it was improved by continuous bladder irragation. Renal clear cell carcinoma was diagnosed in all patients, and no recurrence occured after 18 to 51 months of follow-up.

Laparoscopic partial nephrectomy may be a new alternative treatment for highly selective patients with renal cell carcinoma and renal vein tumor thrombus. However, due to the limited data at present, the safety and effectiveness of laparoscopic partial nephrectomy can not be evaluated accurately. Radical nephrectomy is still the standard treatment for such patients.