Retroperitoneal Laparoscopic Marsupialization of Simple Renal Cyst / 대한비뇨기과학회지

PURPOSE: The minimally invasive technique in urologic treatment such as percutaneous cyst aspiration with sclerotherapy is increasing in recent years to treat symptomatic simple renal cyst. However, this method has a high recurrence rate. The laparoscopic approach can be an alternative method which is far less invasive than open surgery and less recurrence rate than sclerotherapy. Furthermore, the retroperitoneal approach can avoid unnecessary intraperitoneal manipulation and thereby reduce complications such as injury and adhesion of the bowel. We evaluated the recurrence rate, hospital stay, and postoperative morbidity of retroperitoneal laparoscopic marsupialization of simple renal cyst. MATERIALS AND METHODS: From July 1996 to May 1997, 27 patients(male 7, female 20) with simple renal cyst, presenting with pain(14 patients), recurrent cyst after percutaneous aspiration(9), and incidentally found renal cyst(4) was managed with retroperitoneal laparoscopic marsupialization of simple renal cyst. Mean patient age and cyst size were 50 years(range 35-66 years) and 7.8cm(range 3.0-12.0cm), respectively. RESULTS: Mean operative time, hospital stay, and follow-up period were 58.9 minutes(range 40-110 minutes), 2.3 days(range 1-4 days) and 14.2 months(range 6-25 months), respectively. There was no recurrence and cytologic and pathologic examinations were benign in all patients. There was no significant difference in the operative time according to the position and the side of the renal cyst. CONCLUSIONS: Retroperitoneal laparoscopic cyst marsupialization is an effective therapy for recurrent or symptomatic large simple renal cyst with low recurrence rate and postoperative morbidity.

Early Experience of Laparoscopic Renal Cyst Marsupialization / 대한비뇨기과학회지

PURPOSE: To evaluate the eligibility of laparoscopic surgery for the treatment of renal cysts, we analysed our clinical results of laparoscopic renal cyst marsupialization in 9 patients. MATERIALS AND METHODS: Between January 1994 and February 1997, a total of 9 patients with renal cyst underwent laparoscopic surgery. They were 2 men and 7 women 42 to 67 years old. Mean cyst size of the patient was 7.3cm(5-10cm). Presenting symptoms were flank pain in 8 and palpable mass in 1. One patient had previously undergone ultrasonography guided percutaueous aspiration and ablation. One patient had bilateral renal cyst. Initially the procedures had been performed via the transperitoneal approach in 4 patients after that we attempted retroperitoneal access for laparoscopy in 5 patients(6 renal units). During the operation cyst fluid was obtained for cytologic examination and cyst walls were excised and sent for pathological examination. RESULTS: Mean operation time was 2 hours and 14 minutes. Mean hospital stay was 5.9 days. Perioperative complications were pain(20%), bleeding(10%), subcutaneous emphysema(20%) and pneumothorax(10%). Bleeding was minimal but 2 units of packed red cell were needed in 1 patient. Conversion to open surgery from laparoscopic procedure was needed in 1 patient. Biopsy results were negative for carcinoma. All patients were asymptomatic at a mean follow up of 12.5 months. CONCLUSIONS: Laparoscopic renal cyst marsupialization for symptomatic renal cysts seems to be a safe and effective alternative to open surgery.