Different Successful Management Strategies for Obstructing Renal Parapelvic Cysts

Rossi, Sabrina; Koo, Brendan; Riddick, Antony C. P.; Shah, Nimish; Stewart, Grant D.

doi:10.1159/000475886

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…The aforementioned preoperative examinations are necessary to diagnose the disease. For example, Sabrina H Rossi et al [ 25 ] reported that a case of parapelvic cyst with hydronephrosis was misdiagnosed as simple hydronephrosis, in which the patient underwent ureteral stenting but the symptoms recurred several months after stent removal. Ruslan Korets et al [ 20 ] reported a case of persistent urinary leakage after calyceal ablation.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of intraoperative real time ultrasound-assisted flexible ureteroscopic holmium laser incision and internal drainage in the treatment of parapelvic cysts

Huang

Yang

et al. 2022

BMC Surg

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Objective This study aims to investigate the efficacy and safety of intraoperative real time ultrasound-assisted flexible ureteroscopic holmium laser incision and internal drainage in the treatment of parapelvic cysts, and to review recently published relevant literature. Method This is a retrospective study in which the clinical data of 47 patients who underwent flexible ureteroscopic holmium laser incision and internal drainage of parapelvic cysts in our center from March 2017 to March 2021 were retrospectively analyzed. A literature search was conducted to review and summarize relevant reports on endoscopic treatment of parapelvic cysts published in the past 10 years. Results Among 47 patients with parapelvic cysts who underwent flexible ureteroscopic holmium laser incision and internal drainage, 12 (25.53%) cases had a typical cyst wall bulging into the collecting system under flexible ureteroscope. As the cyst wall was thin and translucent in these cases, ultrasound was not used during the operation. The cysts of the remaining 35 patients were located with the aid of intraoperative real time ultrasound, and all underwent successful operation. No serious surgical complications occurred after surgery. The patients were followed up for 12–24 months after operation. The cyst in one case was observed larger than its original size before operation, so recurrence was considered. In another two cases, the diameters of the cysts were more than half of their original diameters before operation. Thus, the efficacy was poor in the three cases. For the remaining 44 cases, there was no obvious cyst observed or the diameter of the cysts was less than half their preoperative level. Conclusion The approach of ultrasound-assisted flexible ureteroscopic holmium laser incision and internal drainage in the treatment of parapelvic cysts is safe and effective, which helps to solve the problem of localization of atypical parapelvic cysts on endoscopic findings.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy of intraoperative real time ultrasound-assisted flexible ureteroscopic holmium laser incision and internal drainage in the treatment of parapelvic cysts

Huang

Yang

et al. 2022

BMC Surg

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“…Open surgery is rarely used because it is quite invasive and is associated with more tissue trauma. Percutaneous renal cyst puncture produces less trauma but has a higher recurrence rate 12 . Injecting a sclerosant into the cyst can reduce the recurrence rate.…”

Section: Discussionmentioning

confidence: 99%

The preliminary experience of methylene blue assisted laparoscopy in the treatment of renal parapelvic cysts

Chen

et al. 2020

Sci Rep

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Renal cyst is a common disease in humans and laparoscopic renal cyst decortication is the gold standard for treatment. However, specialized surgical skills are required for the treatment of renal parapelvic cysts. In this study, we describe an improved laparoscopic method for the treatment of renal parapelvic cysts involving the use of continuous infusion of methylene blue. Sixteen patients with renal parapelvic cyst were enrolled in this study. All patients underwent retrograde ureteral catheterization, with continuous perfusion of the renal pelvis using a solution of 0.2% methylene blue and saline, during laparoscopic decortication of the parapelvic cyst. In one patient, the cyst communicated with the renal collection system which was injured, but this was immediately repaired intraoperatively. All operations were successful, and none was converted to open surgery. There were no occurrences of persistent urinary fistula, bleeding, or other complications postoperatively. All patients were followed-up for 3–24 months, and results of postoperative imaging investigations revealed that all of our patients experienced either complete recovery or a greater than 50% decrease in size of the cysts. Our study demonstrates that methylene blue-assisted laparoscopic treatment is a safe, effective and practical method for the treatment of renal parapelvic cysts.

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“…In comparison with laparoscopic unroofing, the current “gold standard” treatment for RSCs [20-23], RIR-HoLI is less invasive, does not require general anesthesia, and is associated with a shorter surgical time and hospital stay. Most importantly, it is highly effective but with a lower risk of complications.…”

Section: Discussionmentioning

confidence: 99%

Retrograde Intrarenal Surgery for Symptomatic Renal Sinus Cysts: Long-Term Results and Literature Review

et al. 2018

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Introduction: To report the long-term multicenter experience with retrograde intrarenal holmium-laser incision (RIR-HoLI) in the management of symptomatic renal sinus cysts (RSCs). In the literature, RIR-HoLI has been shown to be a safe and effective treatment, but there are only a few reports regarding long-term results and reproducibility of this procedure. Material and Methods: From June 2010 to June 2015, 14 patients with symptomatic RSCs underwent RIR-HoLI. The mean age was 52.1 ± 11.28 years (range 28–77) and the mean cyst size was 53.2 ± 14.23 mm (range 35–90). In all cases, contrast-enhanced computer tomography (CT) showed compression of the renal pelvis by the cyst (no malignancy). Surgical outcome was assessed in terms of symptoms improvement (measured by Visual Analogue Scale [VAS] for pain) and renal ultrasound findings at 3–6–12 months postoperatively and then yearly. CT scan was carried out at 12 months follow-up. Results: RIR-HoLI was successful in all patients. The mean operative time was 47.8 ± 13.54 min (range 30–80) and mean hospital stay was 3.5 days (range 2–5). There were 2 Clavien grade II complications (flank pain and urgency delaying discharge). After surgery, all patients became asymptomatic (VAS score change, p = 0.0001). One patient had persistence of a small cyst (10 mm). Mean follow-up is 44 ± 17.24 months (range 24–84); all patients remained asymptomatic, with no signs of recurrence. Conclusions: RIR-HoLI proved to be a safe and effective treatment for symptomatic RSCs. In our experience, it provided excellent long-term results and was reproducible at 4 different institutions.

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Different Successful Management Strategies for Obstructing Renal Parapelvic Cysts

Cited by 5 publications

References 5 publications

Clinical efficacy of intraoperative real time ultrasound-assisted flexible ureteroscopic holmium laser incision and internal drainage in the treatment of parapelvic cysts

Clinical efficacy of intraoperative real time ultrasound-assisted flexible ureteroscopic holmium laser incision and internal drainage in the treatment of parapelvic cysts

The preliminary experience of methylene blue assisted laparoscopy in the treatment of renal parapelvic cysts

Retrograde Intrarenal Surgery for Symptomatic Renal Sinus Cysts: Long-Term Results and Literature Review

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