The Effect of Two-Injection Ethanol Sclerotherapy with 5-Minute Duration of Exposure Time in Simple Renal Cysts

Abstract

Under ultrasound guidance, the renal cyst was punctured and a 7 Fr pigtail catheter was inserted, and then complete aspiration of the cystic fluid was performed. Then, 99.9% ethanol in a quantity amounting to 1/3-1/2 of the aspirated volume was infused into the cyst and it was immediately removed. The same amount of ethanol was re-infused and removed after 5 minutes. Follow-up examination was performed using ultrasound or CT images at least 3 months after the procedure and pre-and post-treatment cyst volumes were estimated. The therapeutic response was classified as either complete success (volume reduction, ≥ 95%), partial success (volume reduction, 50-95%), or failure (volume reduction, < 50%) based on the volume reduction rate. Results: The average volume reduction rate was 96.3%. The rates of complete success, partial success and failure were 80% (n = 24), 20% (n = 6), and 0% (n = 0), respectively. There was no complication except for minor flank pain. Conclusion: Two-injection ethanol sclerotherapy with 5-minute exposure time represents a simple and effective treatment for simple renal cysts. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Index terms

Review of outcomes of using lower ethanol concentration (83%) in percutaneous ultrasound-guided renal cyst sclerotherapy in dogs

“…First, if percutaneous access is difficult, PRCS may not be possible, depending on the cyst’s location. In this case, laparoscopic surgery, surgical marsupialization, or nephrectomy may be good options [ 10 11 28 ]. However, these surgical methods are highly invasive.…”

“…Therefore, if possible, adopting a non-invasive alternative method is beneficial for patient’s prognosis and owners who care for the patient [ 4 29 ]. To avoid the side effects of ethanol, cystic fluid drainage without sclerosing may be selected [ 10 17 ]. However, this method is not recommended because it is associated with a high recurrence rate [ 3 15 ].…”

“…The volume change was compared, and the success of the procedure and the occurrence of side effects were evaluated. The volume reduction rate was defined using the following formula [ 10 ]: Volume Reduction Rate (%) = [(Cyst Volume Just Before PRCS) − (Final Cyst Volume)]/(Cyst Volume Just Before PRCS) × 100. The volume reduction rate was classified as follows: < 50% of initial volume, fail; ≥ 50% and < 80% of initial volume, partial success; ≥ 80% and < 95% of initial volume, great success; ≥ 95%, complete success.…”

“…Treatment methods for renal cysts include percutaneous sclerotherapy, percutaneous aspiration of the cyst without sclerosant injection, nephrectomy, marsupialization, and cyst resection [ 5 10 11 ]. Among these, percutaneous renal cyst sclerotherapy (PRCS) has advantages such as fewer side effects including pain and bleeding, and a shorter hospital stay compared to other procedures [ 8 12 ].…”