Comparison of aspiration-sclerotherapy versus laparoscopic decortication in management of symptomatic simple renal cysts

Shao, Qiang; Xu, Jianfeng; Adams, Tamara S.; Tao, Sha; Yon, Cui; Shen, Hua; Cao, Wenzhou; Xie, Jian‐Jun; Fan, Youzhang; Zhang, Yuanyuan; Huang, Min

doi:10.3233/xst-130393

Cited by 23 publications

(28 citation statements)

References 13 publications

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“…Surgery carries a higher morbidity and longer hospital stay, and is reserved for PS failures or for atypical cysts. An RCT of 40 symptomatic renal cysts found percutaneous aspiration and sclerotherapy with polidocanol equal in efficacy with lower morbidity and shorter hospital stay in comparison with laparoscopic deroofing [364], supporting results from retrospective studies [365]. Percutaneous therapy is indicated in nearly all symptomatic patients, with the exception of suspected malignancy.…”

Section: Multidisciplinary Decision Makingmentioning

confidence: 72%

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III – Abdominal Treatment Procedures (Long Version)

et al. 2015

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The third part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound (INVUS) assesses the evidence for ultrasound-guided and assisted interventions in abdominal treatment procedures. Recommendations for clinical practice are presented covering indications, contraindications, and safe and effective performance of the broad variety of these techniques. In particular, drainage of abscesses and fluid collections, interventional tumor ablation techniques, interventional treatment of symptomatic cysts and echinococcosis, percutaneous transhepatic cholangiography and drainage, percutaneous gastrostomy, urinary bladder drainage, and nephrostomy are addressed (long version).

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Section: Multidisciplinary Decision Makingmentioning

confidence: 72%

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III – Abdominal Treatment Procedures (Long Version)

et al. 2015

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“…Due to the limited comparative studies and heterogeneity of some statistics, more researches are needed to validate our conclusion. Table Author Complications Pain Hypertension Hemorrhage Fever Efesoy [11] 2015 AS 2 LD 1 Bas [12] 2015 AS 15 3 LD 7 4 1 Shao [13] 2013 AS LD Agarwal [14] 2012 AS LD Arisan [15] 2006 AS 15 LD OKEKE [16] 2003 Figure 1 Flow chart of the strategy of search and selection…”

Section: Discussionmentioning

confidence: 99%

“…Three studies [11,13,14] involving 1314 patients compared the treatment time between AS group and LD group. The time of AS therapy was 30.55 minutes on average, comparing to that of LD was 79.10 minutes.…”

Section: Treatment Timementioning

confidence: 99%

Aspiration-Sclerotherapy Versus Laparoscopic De-roofing in the Treatment of Renal Cysts: Which is better?

Zhang

Cao

Han

et al. 2020

Preprint

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Background: To compare the clinical efficiency between aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) in the management of renal cysts through meta-analysis of comparative studies.Method: A comprehensive literature search was performed by PubMed, MEDLINE, Ovid and Web of Science for relevant studies published up to January 2020. The statistical analyses were conducted with Review Manager 5.3.0 and Stata 15.1. The sensitivity analysis was also carried out to confirm the reliability of this Meta-analysis.Results: Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that LD group was superior in symptomatic successful rate [Odds Ratio(OR): 0.28; 95%Confidence Interval(CI): 0.09 to 0.86；P=0.03), radiological successful rate (OR: 0.06; 95%CI: 0.02 to 0.15; P<0.01) and recurrence rate (OR: 6.08; 95%CI: 2.81 to 13.15; p<0.01). Nevertheless, AS group had shorter treatment time [Mean Difference(MD)：-51.10; 95% CI：-73.01 to -29.20; p<0.01]. No statistically significant difference was showed in the rate of complications (OR: 3.19; 95% CI: 0.39 to 25.88; P=0.28).Conclusions: In our meta-analysis, LD had higher symptomatic successful rate, radiological successful rate as well as lower recurrence rate than AS, while the treatment time was longer.

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“…Presence of a cyst with a diameter of >4 cm is one of the inclusion criteria for SRC sclerotherapy 14,15 . Large cysts (>8 cm) tend to fold after cavitary collapse.…”

Section: Discussionmentioning

confidence: 99%

A Painless and Time-Saving Modified Technique for Simple Renal Cyst Treatment with Single-session Ethanol Sclerotherapy

Zhang

Xiong

Jiang

et al. 2020

Sci Rep

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Percutaneous puncture ethanol sclerotherapy is a simple, effective, minimally invasive, and inexpensive procedure to manage symptomatic simple renal cysts. We modified specific technical aspects to balance certain potential intraprocedural factors for ensuring minimal procedural pain and duration as well as maximal clinical therapeutic effects and evaluated the safety and efficacy of this modified technique. A total of 84 eligible patients underwent computed tomography-guided single-session ethanol sclerotherapy using the conventional (group A) or modified (group B) technique. In group B, the puncture route was modified from tansparenchymal to direct for reducing renal injury, and preinjection of low-dose intracystic lidocaine was used to control distending pain caused by ethanol injections; therefore, greater ethanol volumes could be injected for improving the resistance and contact of ethanol with the cyst wall, precluding the need for patient repositioning multiple times to decrease procedural duration. Visual analog scale score for pain and procedural time were significantly higher in group A than in group B. The complication rate was slightly higher in group A than in group B, but the success rate was comparable between the two groups. These results suggest that the modified technique is painless, time-saving, and injury-reducing and can thus improve medical care.Simple renal cysts (SRCs) are one of the most commonly acquired renal cystic diseases and are frequent in the elderly given that their prevalence increases with age 1 . Symptomatic SRCs present common clinical symptoms such as flank pain or mass, hypertension, and hydronephrosis. Percutaneous ethanol sclerotherapy is a simple, effective, minimally invasive, and inexpensive treatment for symptomatic SRCs 2 . Therefore, it is often the first-line procedure and is widely used in clinical practice; however, the procedure has not been standardized to date 3 . The conventional technique reported by Xu et al. 4 is used in early stages of the disease, and its advantages include the use of three-way drainage tube, which prevents air from entering the cyst, and of high ethanol concentration over repeated cycles of injection-suction, which eliminate the step of ethanol dilution 4 . Moreover, fragments of protein-denatured substances are removed to allow a directly contact between ethanol and epithelial lining of the cyst wall. The computed tomography (CT) value is used to monitor ethanol concentration for improving treatment efficacy 4,5 , which is based on the linear correlation between ethanol concentration/density and CT attenuation; when the CT value is lower than −190 HU, ethanol concentration is considered to be greater than 90%.However, we have encountered a few problems in the course of our clinical practice. First, this puncture route can damage renal tissues, thus increasing the risk of intracystic hemorrhage and hematuria 6 . Second, patients complain of distending pain caused by ethanol injections 7 . Third, the patient's position needs to be chan...

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Comparison of aspiration-sclerotherapy versus laparoscopic decortication in management of symptomatic simple renal cysts

Cited by 23 publications

References 13 publications

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III – Abdominal Treatment Procedures (Long Version)

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III – Abdominal Treatment Procedures (Long Version)

Aspiration-Sclerotherapy Versus Laparoscopic De-roofing in the Treatment of Renal Cysts: Which is better?

A Painless and Time-Saving Modified Technique for Simple Renal Cyst Treatment with Single-session Ethanol Sclerotherapy

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