To compare the efficacy of retroperitoneal laparoscopic partial nephrectomy (RLPN) with retroperitoneal laparoscopic radical nephrectomy (RLRN) for complex stage T_1b renal tumors.

The clinical data of 68 patients with complex T_1b renal tumors in Xi'an People's Hospital from November 2014 to November 2015 were retrospectively included. The patients were divided into RLPN group and RLRN group, each of 34 cases. The RLPN group received retroperitoneal laparoscopic partial nephrectomy, and the RLRN group received retroperitoneal laparoscopic radical nephrectomy. The perioperative related indexes, renal function and survival were compared between the two groups.

There was no statistically significant difference in operation time, intraoperative blood loss, indwelling drainage tube time, postoperative hospital stay and occurrence of complications between the two groups (P>0.05). There was no interaction between time and method on estimated glomerular filtration rate (eGFR) (P>0.05), but the main effect of time and method on eGFR was significant (P<0.05), the level of eGFR in RLPN group was higher than that in RLRN group at 6 months after operation. During the follow-up period, Kaplan-Meier analysis showed that the 5-year overall survival rate and disease-free survival rate in the RLRN group were 88.2% and 85.3% respectively. The 5-year overall survival rate and disease-free survival rate of patients in the RLPN group were 91.2% and 82.4% respectively, and there was no significant difference between the two groups (χ²=0.188, 0.082, P=0.664, 0.774).

RLPN is safe and effective, can retain normal renal tissue to the maximum extent, protect renal function, improve postoperative quality of life, and has the same long-term efficacy as RLRN, which is worthy of widespread clinical application.