The incidence of renal cancer (RCC) has shown the following new features in recent years: 1) the overall incidence is on the rise; 2) the population affected is younger; 3) the tumor size is smaller: 70% of RCC is < 7 cm in diameter (cT1) at diagnosis. The above changes are mainly attributed to two points: 1) the change of people's lifestyle, the improvement of health awareness and the popularization of health check-ups; 2) the development and popularization of related imaging equipment, which effectively realized the forward movement of kidney cancer diagnosis. There are two milestones in the surgical treatment of kidney cancer: First, the radical kidney cancer surgery proposed by Robson in 1963, which laid down the basic scope and elements of kidney cancer surgery, and has been used for more than 50 years since then, except that there are certain controversies on the timing and scope of lymph node dissection; second, the proposed kidney unit preservation surgery (NSS), also known as partial nephrectomy (PN), which has been adopted from the beginning. The second is the proposed NSS, also known as partial nephrectomy (PN), which has fundamentally changed the standard surgical approach for so-called "small kidney cancer" or "early kidney cancer". Both procedures have always existed side by side. In the last decade, due to advances in surgical techniques and the development of related instruments and equipment, the question of which procedure is more reasonable for smaller renal cancers has become the focus of academic research and discussion, and has led to challenges and even reversals of long-established consensus conclusions. Currently, widely used guidelines for the treatment of kidney cancer mainly include those developed by the European Association of Urology (EAU), the American Urological Association (AUA) and the Chinese Urological Association (CUA), which is adopted in China. According to the 2002 NCCN kidney cancer staging, kidney cancers with coexistence of both procedures are mainly concentrated in T1a and T1b, i.e., the maximum diameter of tumor is 4cm and 7cm, respectively. For the smaller volume of T1a kidney cancer, a large amount of evidence-based evidence in the last decade has fully demonstrated that PN (NSS) is comparable to RN in terms of tumor control and safety, and is the standard surgical approach for T1a. The major international guidelines (EAU, AUA) all clearly state that there is no significant difference in overall survival, tumor-specific survival and other oncologic indicators between renal unit preserving surgery and standard radical kidney cancer surgery, and therefore renal unit preserving surgery is preferred as long as technical conditions (personnel, instruments, etc.) allow. Therefore, there is no controversy in choosing kidney unit-preserving surgery for kidney cancer less than or equal to 4 cm. Inderbir Gill, an authority on renal laparoscopic surgery, compared laparoscopic partial nephrectomy (LPN) and laparoscopic radical nephrectomy (LRN) for RCC patients with T1b and demonstrated no statistical difference in recurrence-free survival, overall survival, or tumor-specific survival. The problems of radical nephrectomy (RN) for renal cancer have received increasing attention in recent years. The first is the long-term impact on renal function. Controlled studies have shown that NSS has a significantly higher effect on 24-hour creatinine clearance than the RN group at 6 months postoperatively. a prestigious paper published in Lancet Oncology in 2006 showed that the incidence of postoperative GFR <45 ml/min/1.73 m2 in a large sample of 662 T1a cases in which NSS or RN was performed was 20% (NSS) and 65 The study published in the New England Journal of Medicine in 2004 showed that chronic kidney disease (CKD) was an independent influencing factor for the occurrence of adverse cardiovascular events after radical nephrectomy (RN) for kidney cancer , and that more than 70% of postoperative limited kidney cancers eventually died from CKD, cardiovascular disease, etc., rather than A study of 1004 patients with T1bRCC at Cleveland Medical Center demonstrated that the incidence of chronic renal insufficiency was significantly higher after radical nephrectomy (RN) than NSS. Whether partial nephrectomy can be performed for larger volumes of RCC and whether NSS is also an option for patients with T2 RCC, although more and more authors are expanding the indications for NSS, the current rationale and conclusions are not yet agreed upon. Although more and more authors are expanding the indications for NSS, there is no consensus on the rationale and conclusions. However, the specific location of the patient's tumor and its proximity to the renal vasculature suggest that partial nephrectomy >7 cm is not an option, but its postoperative tumor control, long-term recurrence, and survival rates remain to be supported by high-level evidence-based evidence. A study published in the European Journal of Urology, Volume 52, 2007, showed that there was no statistical difference in the positive margin rate (PM) between 550 patients with T1a and T1b RCC, and the analysis concluded that larger tumors did not increase the likelihood of PM because of the significant nudging and compression effect on normal renal tissue, the borders of which were easily identified at the time of partial resection. Therefore, it is currently believed that there is no causal relationship between tumor size and positive margin rate (PM). At present, the necessity of adopting NSS still has not received sufficient attention in China, and therefore, radical nephrectomy (RN) for renal cancer still suffers from overuse. The main reasons are: 1. The constraints of traditional concepts. Both patients and physicians believe that older patients with more combined major organ diseases and poor surgical tolerance should prefer radical nephrectomy (RN) for the reason that the operation time is shorter and the possibility of postoperative complications is lower. In fact, this is a misconception that needs to be corrected. The more patients mentioned above should choose partial nephrectomy (PN), which will benefit more in terms of preserving more kidney units and reducing postoperative CKD, cardiovascular and cerebrovascular diseases and non-tumor mortality, provided of course that the operator is skilled in PN, and there is actually no significant difference in operation time and postoperative complications. 2.According to the previous concept, tumor larger than 4 cm is the standard indication to abandon partial nephrectomy and choose radical nephrectomy for kidney cancer, and this standard is still implemented in tertiary medical centers at home and abroad so far. 3. LRN was first popularized at the beginning of the development of urological laparoscopy, and LPN lagged behind due to its higher technical requirements for the operator. From 2001 to 2006, the proportion of NSS for renal tumors in tertiary care centers in the United States was only 20%, whereas currently it has reached 65%. For example, the proportion of T1a and T1b partial nephrectomies (PN) performed at Memorial Sloan Kettering Cancer Center in New York has reached 90% and 60%, respectively. Thus, the rate of NSS for kidney cancer can be a reflection of the standard of care in a urology department.