Laparoscopic decortication of symptomatic simple renal cysts: 10‐year experience from one institution

Abstract

OBJECTIVETo assess the long-term results by symptomatic and radiological outcome of laparoscopic decortication of renal cyst, first reported in 1992. PATIENTS AND METHODSWe retrospectively reviewed the records of 36 patients who had a total of 36 laparoscopic decortications at our institution between December 1993 and March 2004. Of these cysts, 30 were peripheral and six were peripelvic cysts; the patients were asked if they had pain or not. Changes of cyst size after decortication were determined by computed tomography and the serial changes of each cyst were evaluated as the percentage of the diameter before surgery. The relationships between radiological and symptomatic outcome or cyst location were examined. RESULTSPeri-operative morbidity was satisfactory; with a mean (range) follow-up of 67.2 (13-128) months the symptomatic and radiological success rates were 92% (33 of 36) and 81% (25 of 36), respectively. Peripelvic cysts were significantly correlated with radiological failure. Symptomatic improvement was evident by 3 months, while radiological improvement continued for up to 3-4 years after surgery. Seven asymptomatic patients with radiological failure selected a conservative follow-up. CONCLUSIONSLaparoscopic decortication is safe and provides long-term satisfactory symptomatic results. The radiological improvement was slower than the symptomatic improvement and several cysts remained large, indicating some reduction in volume that was enough to improve the symptoms. This procedure is still challenging for peripelvic cysts in terms of radiological results, yet feasible for the clinical outcome.

Laparoscopic Simultaneous Treatment of Peripelvic Renal Cysts and Stones: Case Series

“…Suspicion of peripelvic cysts often arises when examining renal US, but only CT scans with intravenous injection of contrast medium and late excretory phase can reveal exact number and size, distinguish between hydronephrosis, and exclude their communication to the collecting system. 37 The treatment of symptomatic peripelvic cysts differs from the peripheral cysts. Drainage of the collecting system, the primary goal, 3 could be challenging.…”

Laparoscopic renal surgery for benign disease

“…Atug et al [42] recently described 45 patients who underwent laparoscopic cyst decortication and reported 91.1% symptomatic success (median follow-up 52 months) and 95.5% radiographic success (median follow-up 39 months). Other series with similar findings have been reported [43,44]. As an alternative to cyst decortication for symptomatic ADPKD patients, Resnick et al [45] recently described an innovative approach of laparoscopic renal denervation in four patients who remained pain-free at short-term follow-up.…”

Simultaneous Treatment of Renal Cysts and Stones with Single-Session Retroperitoneoscopic Renal Cyst Decortication and Retroperitoneoscopy-Assisted Percutaneous Nephrolithotomy

“…Only a very small subset of patients with renal cysts needs surgical intervention. The treatment indications include abdominal and/or flank pain, hematuria, hypertension, recurrent urinary infection, and obstruction in the collecting system due to compression [12,13,14,15,16]. In our series, 9 patients had recurrent cyst after percutaneous aspiration and sclerotherapy, 3 infected polycystic kidney, and 3 caliceal obstruction.…”