Complex large renal cancer treatment Complex large renal cancer refers to the tumor diameter larger than 7cm, accompanied with lymph node metastasis, invasion of surrounding organs and vena cava thrombosis, which is difficult to operate with much bleeding. In order to reduce the difficulty and complication rate of surgery, we have refined the “four key points” of surgery, i.e., improving surgical exposure, preventing cancer thrombus dislodgement, anticipating the bleeding site, and reducing the damage of neighboring organs, which greatly improve the success rate of surgery for complicated large renal cancer. 2.High proportion of minimally invasive surgeries and many means (1) Traditional laparoscopic surgery: At present, more than 70% of kidney cancer surgeries and more than 90% of early kidney cancer surgeries of Changhai Hospital’s Department of Urology’s Wang Linhui Kidney Cancer Team have been completed by laparoscopic technology. This procedure has the advantages of fast postoperative recovery, light pain, small incision on the body surface, etc., and the tumor treatment effect is good through the follow-up observation, which realizes the leapfrog development of surgery from the “giant invasive” to the “minimally invasive” mode. Open Surgery Traditional Laparoscopic Surgery (2) Single-hole Laparoscopic Surgery – the earliest in China and with the largest number of completed cases: i.e., all surgical operations are completed through a single puncture hole on the surface of the body (the puncture hole is usually chosen to be the umbilical cord hole and other hidden parts), which further reduces the trauma of the surgery, further alleviates the postoperative pain, and leaves only a small, hidden scar on the surface of the body. In December 2008, he was the first to carry out single-port laparoscopic surgery in China and completed the first single-port laparoscopic nephrectomy in China, and in November 2011, he completed the first single-port laparoscopic live donor nephrectomy in China. He has been invited many times to give surgical demonstrations in many hospitals across China and instructed to carry out single-hole laparoscopic surgery. He has organized many international training courses and is at the international leading level in single-port laparoscopic technology. Open Surgical Incision Traditional Laparoscopic Surgical Incision Single-hole Laparoscopic Surgical Incision (3) Robot-assisted Laparoscopic Kidney Cancer Surgery: Our department is one of the earliest to carry out robot-assisted laparoscopic surgery in China, and our renal cancer specialization team has accumulated rich experience in robot-assisted laparoscopic kidney cancer surgery in particular. With the cooperation of flexible robot arm and high-definition three-dimensional vision, the surgical details are displayed more clearly and the operation is more delicate, which can realize the minimally invasive treatment of complicated kidney cancer surgery. Especially, the advantages of robot-assisted laparoscopy in renal unit preservation surgery (kidney preservation surgery) for kidney cancer can be fully utilized, which enhances the clinical application value and medical significance of partial nephrectomy in terms of quantity (preservation ratio) and quality (preservation of kidney function). First, the surgical indications for partial nephrectomy have been expanded, so that more kidney cancer patients have their kidneys preserved; second, the operation time has been shortened, especially the thermal ischemia time has been shortened, the damage of renal function has been reduced, and the quality of preserved kidneys has been improved; third, the safety of the operation has been improved, and the incidence of postoperative secondary hemorrhage has been further reduced, and postoperative hospital stay and physical recovery time have been further shortened, so that patients can return to the The postoperative hospitalization time and physical recovery time are further shortened, enabling patients to return to work earlier. (4) Trans-natural cavity surgery (NOTES): Our department is one of the earliest units in China to try to carry out renal surgery through natural cavities (vagina, bladder, stomach, rectum, etc.). This procedure has the advantage of no scar on the body surface in the real sense, and is highly favored by young female patients and beauty lovers. Transvaginal renal surgery (5) Cryotherapy: For kidney cancer patients with poor physical condition or serious comorbidities (advanced age, severe hypertension, diabetes, etc.), cryotherapy can be used to achieve the purpose of preserving kidney and effectively treating tumor at the same time. 3. Mature technology and various methods of kidney preservation surgery We can choose appropriate kidney preservation surgery methods according to the patient’s age, physical condition, clinical characteristics of the tumor, such as open surgery, laparoscopic surgery, single-port laparoscopic surgery, robotic laparoscopic surgery, cryotherapy, etc., so that patients with renal cancer can have their kidneys preserved as well as their tumors treated. At present, the proportion of kidney-preserving surgery in our department has reached more than 30%. Studies have shown that kidney preservation surgery can achieve the same tumor control effect compared with radical nephrectomy, and the preserved kidney function can reduce the incidence of postoperative long-term renal insufficiency and prolong the survival time. Schematic diagram of kidney preservation surgery 4. Experienced in targeted drug therapy for advanced kidney cancer Our department is at the leading level in China in standardized drug therapy for advanced kidney cancer, which has achieved good clinical efficacy and accumulated rich clinical experience. It is the designated hospital for China Charity Federation and China Cancer Foundation’s patient assistance program, and the cooperation hospital for many global multi-center targeted drug clinical research. 5.Many scientific research achievements in renal cancer The renal tumor work team has obtained many fund grants from the National Natural Science Foundation of China, Shanghai Natural Science Foundation, Shanghai Science and Technology Key Project of Shanghai Science and Technology Commission, etc., with a total funding strength of more than 5 million RMB, in the basic and clinical research of renal cancer. In China, we have innovatively carried out research on the intra-nuclear signaling pathway of renal cancer metastasis, which provides a new vision for exploring the treatment of metastatic renal cancer. Over the past three years, more than 30 papers have been published in domestic and international professional journals on basic and clinical research of kidney cancer, including more than 10 papers indexed by SCI. His research results have won the second prize of Shanghai Scientific and Technological Progress and the first prize of Shanghai Medical Science and Technology Award.