Renal function preservation is a growing concern in the surgical management of kidney tumors, particularly with the rise in chronic kidney disease worldwide. Recent surgical innovations have focused on modifying renorrhaphy techniques to minimize renal damage. Emerging evidence suggests that omitting cortical suturing may reduce operative time, blood loss, and renal parenchymal loss without increasing major complications. This randomized controlled trial aims to compare outcomes between medullary-only and combined cortical-medullary suture techniques during robot-assisted partial nephrectomy, with the goal of identifying the approach that best balances functional preservation and surgical safety.
Diagnosis of renal mass confirmed by computed tomography (CT) or magnetic resonance imaging (MRI)
Indication for partial nephrectomy
Written informed consent
Expected survival of at least 6 months
Solitary kidney
Multiple or bilateral renal masses if more than one mass is operated on simultaneously or within less than 4 months
Hepatic or renal toxicity grade ≥ 2 with glomerular filtration rate (GFR) < 30 according to Common Terminology Criteria for Adverse Events (CTCAE v4)
Bleeding diathesis