Management of Renal Cysts

Abstract

Background and Objectives:Renal cysts have a high prevalence in the general population, and their estimated incidence increases with age. Renal cyst aspiration (usually with sclerotherapy) or open/laparoscopic decortication is a generally effective and safe method in the treatment of symptomatic simple renal cysts. The success rates of laparoscopic decortication and percutaneous aspiration-sclerotherapy were compared to assist in the decision making for the procedure.Methods:A total of 184 patients with symptomatic simple renal cysts were treated with either laparoscopic decortication in 149 cases or percutaneous aspiration-sclerotherapy in 35 cases. The follow-up period was approximately 35 months, and the symptomatic and radiologic success rates of the 2 techniques were compared retrospectively.Results:Laparoscopic decortication was found to have high success rates, a low recurrence rate, and minimal morbidity. Percutaneous aspiration-sclerotherapy is an outpatient procedure with a minimally higher recurrence rate.Conclusion:When a symptomatic cyst is encountered and treatment of the cyst is indicated, laparoscopic decortication is a more efficient method that offers better results than percutaneous aspiration-sclerotherapy.

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

“…Studies reported by Ali et al [20] and Monville et al [19] evaluated the efficiency of ultrasound-guided AS treatment among patients with renal cysts, their results showed that the radiological successful rate were up to 98% and 91.6% respectively meanwhile the complication and recurrence leveled off to zero. However, the rates of radiological success reported by Efesoy et al [11] and Bas et al [12] were 63.2% and 60% separately, which were also presented in Table 2. Ethanol contacting the cyst wall causes protein degeneration, cell death as well as inflammatory fibrosis so that patients should keep 5 to 10 minutes at least in each position according to the diverse cyst size and volume.…”

“…As for the heterogeneity, sensitivity analysis was conducted and delineated in Fig3. In the study of Bas et al [12], the difference of treatment techniques may contribute to the heterogeneity in symptomatic successful rate. Besides, in terms of complication rate, the researches of Agarwal et al [14] and Shao et al [13] only recorded some severe complications such as port infections so that they might omit some information about complications after aspiration treatment, which also brought about the heterogeneity.…”

“…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…”

Endothelin-1 Level in Patients with Simple Renal Cyst

“…The prevalence of simple renal cyst (SRC) is between 20-50% in the general population and the incidence of the condition increases with age. 9 Researchers from Korea reported that the renal cyst prevalence was 2.5% and 1.4% under the age of 40 and increased to 30.1% and 18.3% aged more than 70 years in male and female patients respectively. 10 The general prevalence of renal cyst was 7.8% in all participants.…”

“…Although SRCs are common in the general population they are diagnosed incidentally and the clinical presentations include pain, hematuria, hypertension and urinary system obstruction. 9 Surgical treatment is needed when the patients are symptomatic. Percutaneous aspiration, open surgery and laparoscopic techniques are the treatment modalities.…”