Percutaneous Decortication of Cystic Renal Disease

PURPOSE: To assess the efficacy of percutaneous unroofing in the treatment of simple renal cysts instead of laparoscopic decortication and open surgeries. MATERIALS AND METHODS: From November 2009 to October 2010 at our department, 11 patients with 12 simple cyst units were managed by percutaneous unroofing. All cysts were evaluated with ultrasonography and abdominal computed tomography. If there were no contraindications, cyst wall resection was performed. A standard transurethral resectoscope was used to resect the cyst wall, and the parenchymal portion of the cyst was subsequently cauterized. The drain was left in place for 2 days. RESULTS: At the 5-month follow-up, patients were asked about their symptoms and ultrasonography was performed. From 12 cyst units, 8 were completely resolved, 3 were reduced to less than 50%, and 1 was persistent to near its original size. Success was defined as a more than 50% reduction in cyst volume. CONCLUSIONS: Simple renal cysts can be safely managed by percutaneous unroofing with a success rate of more than 90%. This technique can offer several advantages over open surgery, such as decreased length of hospital stay, improved convalescence, and reduced risk of complications. Percutaneous resection also avoids the multiple trocar sites, extensive dissection, and technical difficulty associated with laparoscopy.

Comparison of the Surgical Outcome of Laparoscopic Cyst Marsupialization for Peripheral and Parapelvic Renal Cysts / 대한비뇨기과학회지

PURPOSE: The location of renal cysts is related with the symptoms and signs. Parapelvic cysts are a rare form of simple renal cysts, and they are much more commonly associated with the symptoms of obstruction, pain, infection and stone formation. We evaluated the surgical outcomes of laparoscopic renal cyst marsupialization for treating the peripheral and parapelvic types of renal cysts. MATERIALS AND METHODS: Between November 1993 and April 2007, 87 patients(91 cases) who presented with symptomatic renal cysts underwent laparoscopic renal cyst marsupialization. There were 76 cases in the peripheral cyst group and 15 cases in the parapelvic cyst group. The mean age was 59.2 years(age range: 20-77) for the patients with peripheral renal cysts and 62.9 years(age range: 47-79) for the patients with parapelvic cysts. RESULTS: The mean operative time was 108 minutes(30-280) for the patients with peripheral renal cysts and 144 minutes(80-270) for the patients with parapelvic cysts, and there was a significant difference(p=0.031). However for the other factors, including the time for the first oral intake, the time to remove the drain and the length of the hospital stay, there were no significant differences(p=0.671, 0.088, 0.268, respectively). Complications, including bleeding and leakage, were detected in 11 patients(14.4%) of the peripheral cyst group and in 4 patients(26.6%) of the parapelvic cyst group; there was a statistical difference(p=0.035). Both groups had a high success rate, 98.7% in the peripheral cyst group and 100% in the parapelvic cyst group. CONCLUSIONS: We found that laparoscopic renal cyst marsupialization was a standard treatment with a high success rate and a fast recovery time. However, performing this for parapelvic cysts showed a longer operative time and a higher complication rate as compared with peripheral cysts.