jsmc-10213
SAFETY AND LONG-TERM OUTCOMES OF TRANS-PERITONEAL LAPAROSCOPIC RENAL CYST DECORTICATION FOR THE TREATMENT OF SYMPTOMATIC SIMPLE RENAL CYST
Ismail Hama Amin Agha Wias a, Sarwar Noori Mahmood a, Saman Anwar Wahid b, and Basheer Anwer Bakr c
a Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
b Sulaymaniyah General Teaching Hospital, Urology Department, Sulaymaniyah, Iraq.
c Kirkuk General Hospital, Urology Department, Iraq.
Submitted: 5/3/2019; Accepted: 5/8/2019; Published: 21/9/2019
DOI Link: https://doi.org/10.17656/jsmc.10213
ABSTRACT
Background
Laparoscopic decortication of symptomatic simple renal cyst has been shown to be an effective durable treatment with minimal complications.
Objectives
To assess the efficacy, safety, and long-term outcomes of transperitoneal laparoscopic decortication of symptomatic simple renal cysts.
Patients and Methods
Thirty-six consecutive patients (20 men; 16 women) who underwent transperitoneal laparoscopic decortication of simple renal cysts at our department between January 2015 and June 2017 were enrolled in the study. The main indication for surgery was flank pain in 24 (66.5%), urinary tract obstruction in 5 (14%), and cyst enlargement on follow up in 7 (19.5%) patients. Only patients with symptomatic simple cysts more than 5 cm (Bosniak I & II) were included in this study, while patients with complicated cysts (Bosniak III & IV) were excluded. The patients were followed up for symptomatic and radiological success. Symptomatic success was defined as a significant pain improvement (using a visual analog pain scale), and procedure success was defined as no recurrence of the cyst and complete pain relief.
Results
All patients had their cysts completely removed laparoscopically with a mean operative time of 47 minutes without major perioperative complications or conversion to open surgery. The mean blood loss was 65 ml, and the mean patient’s hospitalization was 1.3 days. After a mean follow-up of 11.4 months, radiological and symptomatic success was 87.5% and 94%, respectively. Patients having upper pole cyst significantly had longer operative duration and more postoperative pain score compared to the middle and lower pole cysts p-value < 0.05.
Conclusion
Transperitoneal laparoscopic simple cyst decortication is safe and effective with high long-term symptomatic and radiologic success rate.
KEYWORDS
Transperitoneal laparoscopy, Simple renal cyst, Decortication, Symptomatic renal cyst.
References
Bas O, Nalbant I, Sener NC, Firat H, Yeşil S, Zengin K, Yalcınkaya F, Imamoglu A. Management of renal cysts. JSLS: Journal of the Society of Laparoendoscopic Surgeons. 2015 Jan;19(1).
Tefekli A, Altunrende F, Baykal M, Sarilar O, Kabay S, Muslumanoglu AY. Retroperitoneal laparoscopic decortication of simple renal cysts using the bipolar PlasmaKinetic scissors. International journal of urology. 2006 Apr 1;13(4):331-6.
Gadelmoula M, KurKar A, Shalaby MM. The laparoscopic management of symptomatic renal cysts: A single-center experience. Arab Journal of urology. 2014 Jun 30;12(2):173-7.
Tuncel A, Aydin O, Balci M, Aslan Y, Atan A. Laparoscopic decortication of symptomatic simple renal cyst using conventional monopolar device. The Kaohsiung journal of medical sciences. 2011 Feb 28;27(2):64-7.
Erdem MR, Tepeler A, Gunes M, Sılay MS, Akman T, Akcay M, Armagan A, Onol SY. Laparoscopic decortication of hilar renal cysts using LigaSure. JSLS: Journal of the Society of Laparoendoscopic Surgeons. 2014 Apr;18(2):301.
Yang D, Xue B, Zang Y, Liu X, Zhu J, Chen D, Tao W, Shan Y. A modified laparoendoscopic single-site renal cyst decortication: single-channel retroperitoneal laparoscopic decortication of simple renal cyst. Journal of laparoendoscopic & advanced surgical techniques. 2013 Jun 1;23(6):506-10.
Agarwal MM, Hemal AK. Surgical management of renal cystic disease. Current urology reports. 2011 Feb 1;12(1):3-10.
Abbaszadeh S, Taheri S, Nourbala MH. Laparoscopic decortication of symptomatic renal cysts: experience from a referral center in Iran. International journal of urology. 2008 Jun 1;15(6):486-9.
Shao Q, Xu J, Adams T, Tao S, Cui Y, Shen H, Cao W, Xie J, Fan Y, Zhang Y, Huang M. Comparison of aspiration-sclerotherapy versus laparoscopic decortication in the management of symptomatic simple renal cysts. Journal of X-ray science and technology. 2013 Jan 1;21(3):419-28.
Mathew J, Al-Marhoon M, Machado N, William R, Rahman K. Laparoscopic Deroofing of Large Renal Simple Cysts Causing Gastric Symptoms. Sultan Qaboos University medical journal. 2007 Aug;7(2):139.
Asim T Suhail, Bashar D Hasan, Siddeek B Mar'ie, Ahmed MH A'zzaw. Laparoscopic Deroofing of Symptomatic Renal Cysts in Al-Jumhoori Teaching Hospital Mosul City. Iraqi postgraduate medical journal. 2014;13(2).
Li EC, Hou JQ, Yang LB, Yuan HX, Hang LH, Alagirisamy KK, Li DP, Wang XP. Pure natural orifice transluminal endoscopic surgery management of simple renal cysts: 2-year follow-up results. Journal of Endourology. 2011 Jan 1;25(1):75-80.
El-Shazly M, Allam A, Hathout B. Laparoscopic decortication of the simple renal cyst with omental wadding technique: a single-center experience. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2012 Nov 1;22(9):886-8.
Atug F, Burgess SV, Ruiz-Deya G, Mendes-Torres F, Castle EP, Thomas R. Long-term durability of laparoscopic decortication of symptomatic renal cysts. Urology. 2006 Aug 31;68(2):272-5.
Madeb R, Koniaris LG, Patel HR, Dana JF, Nativ O, Moskovitz B, Erturk E, Joseph JV. Complications of laparoscopic urologic surgery. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2004 Oct 1;14(5):287-301.
Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analog scales as ratio scale measures for chronic and experimental pain. Pain. 1983 Sep 30;17(1):45-56.
Okeke AA, Mitchelmore AE, Keeley FX, Timoney AG. A comparison of aspiration and sclerotherapy with laparoscopic de-roofing in the management of symptomatic simple renal cysts. BJU international. 2003 Oct 1;92(6):610-3.
Dong-soo Ryu, Tae-Hee Oh. Laparoscopic decortication of large renal cysts: a comparison between the transperitoneal and retroperitoneal approaches. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2009 Oct 1;19 (5):629-32.
© The Authors, published by University of Sulaimani, College of Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.