Flexible ureteroscopic management of symptomatic renal cystic diseases

Yu, Weifang; Zhang, Dahong; He, Xiang; Zhang, Yuelong; Liao, Guodong; Deng, Gang; Jin, Baiye

doi:10.1016/j.jss.2015.02.046

Cited by 22 publications

(27 citation statements)

References 11 publications

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“…The aim is to prevent further progression of the disease and further damage to kidney function. At present, there are many treatment methods, such as ultrasound-guided puncture drainage + hardener injection [7], traditional open decortication renal cyst surgery, laparoscopic decortication renal cyst surgery, exible ureteroscopic management of renal cyst [8,9] and percutaneous decortication renal cyst surgery [10]. Laparoscopic renal cyst decortication with less trauma, faster recovery and better e cacy is the preferred method for the treatment of simple renal cyst, especially for the younger patients with large cysts [11].A comparative study between the retroperitoneal approach and the peritoneal approach showed that the retroperitoneal approach had signi cantly shorter operative time than the retroperitoneal approach, which reduced the interference to the intestinal tract and signi cantly shortened the recovery time of intestinal function [12].…”

Section: Discussionmentioning

confidence: 99%

A Clinical Control Study on the Retroperitoneal Laparoscopy for Unilateral Simple Renal Cyst Decortication in the Day Ward

Zhu¹,

Bano²,

wu³

et al. 2020

Preprint

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BackgroundUnder the constraints of the increasingly tight medical environment and market economy, day surgery has a good development trend and attracts more and more attention from clinicians. To investigate the feasibility and safety of unilateral simple renal cyst decortication by retroperitoneal laparoscopy in the day ward and to compare the advantages and disadvantages of conventional inpatient ward.MethodsA total of 41 patients with unilateral simple renal cysts meeting surgical indications were included in this study. The patients were divided into the day ward group and inpatient ward group by the patients' wishes. The indexes of operation time, time of hospitalization, intraoperative blood loss, time of postoperative extubation, postoperative complication rate, patients’ satisfaction rate, quality of life scores and total costs of hospitalization were compared between the two groups.Results41 cases of unilateral simple renal cyst decortication were completed successfully. Patients were followed up 10–12 months after surgery. CT or b-ultrasound examination indicated that the original renal cyst had been decorticated surgically and no recurrence of the cyst was observed after 10 months of postoperative follow-up. Time of postoperative extubation were (9.7 ± 1.8) hours and (20.8 ± 5.5) hours, total hospitalization costs were (5790 ± 99.8) RMB and (7496 ± 120.6) RMB, time of hospitalization were (22.7 ± 1.4) hours and (46.4 ± 11.3) hours in the day ward group and the inpatient ward group, respectively. In the above three aspects, the differences between the two groups were statistically significant (P < 0.05).ConclusionIn this study, we concluded that the retroperitoneal laparoscopy for unilateral simple renal cyst decortication in patients aged between 48 and 80 years, with no previous history of abdominal surgery, unilateral renal cysts (Bosniak grades I or II) on CT, ASA grades I or II, and no surgical or anesthetic contraindications, was safe and feasible in the day ward. Its obvious advantages of reducing time of hospitalization and total costs of hospitalization were worthy of clinical promotion.

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Section: Discussionmentioning

confidence: 99%

A Clinical Control Study on the Retroperitoneal Laparoscopy for Unilateral Simple Renal Cyst Decortication in the Day Ward

Zhu¹,

Bano²,

wu³

et al. 2020

Preprint

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“…At 15 months follow-up, there was one recurrence requiring laparoscopic treatment; all 6 symptomatic patients became and remained asymptomatic. In the only available retrospective multicenter series, Yu et al [19] reported that, at mean follow-up of 36 months, 26 (74.3%) of their 35 patients were “cured.” Mean surgical and hospitalization times were 25.38 ± 3.71 min and 3.01 ± 0.57 days respectively; 3 (8.6%) patients experienced Clavien grade I–II complications. The series included 5 patients with polycystic kidneys, in whom the renal volume was decreased by 93.76 ± 7.38 mL per side, on average, compared with pretreatment values.…”

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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“…The incision in the cyst wall created a permanent channel between the renal collecting system and the cyst, which forces the cyst fluid to continuously drain into the pelvis. Other colleagues have reported on the safety and efficacy of this approach 28 , 29 . Admittedly, the natural orifice transluminal endoscopic surgery (NOTES) is the least invasive approach.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous ureteroscopy laser unroofing-a minimally invasive approach for renal cyst treatment

Dirie

Yang

et al. 2017

Sci Rep

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Most simple renal cysts rarely require therapy. When it grows to such a large size, regardless of the presence of symptomatology, surgical intervention is required. In this study, we explored a new approach called percutaneous ureteroscopy laser unroofing for treatment renal cysts and evaluated its safety and efficacy. 71 simple renal cyst patients with surgical indications were enrolled, including 6 patients with a peripelvic cyst and 5 patients coexisting ipsilateral calculi. Under ultrasound guidance, an eighteen-gauge needle was placed inside the cyst cavity, and a guidewire was introduced followed by sequential dilation up to 28 F. The extra-parenchymal portion of cyst wall was dissociated and incised using either a Thulium or Holmium laser, and a pathological examination was performed. Renal calculi were treated simultaneously. For peripelvic cyst patients, one end of a double-J stent was inserted into the cyst cavity to prevent auto-closure. Mean of 11.7 months follow-up, the results showed that the cyst was completely resolved in 53 patients, its size was reduced to less than 50% in 15 patients, and treatment failed in only 3 anterior cyst patients, suggesting that percutaneous ureteroscopy laser unroofing is an effective and less invasive alternative for treatment of renal cysts in selected patients.

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Flexible ureteroscopic management of symptomatic renal cystic diseases

Cited by 22 publications

References 11 publications

A Clinical Control Study on the Retroperitoneal Laparoscopy for Unilateral Simple Renal Cyst Decortication in the Day Ward

A Clinical Control Study on the Retroperitoneal Laparoscopy for Unilateral Simple Renal Cyst Decortication in the Day Ward

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

Percutaneous ureteroscopy laser unroofing-a minimally invasive approach for renal cyst treatment

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