727 LAPAROSCOPIC DECORTICATION OF SYMPTOMATIC SIMPLE RENAL CYST: 15-YEAR EXPERIENCE FROM ONE INSTITUTION

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics/Laparoscopy/Ureteroscopy I1 Apr 2010727 LAPAROSCOPIC DECORTICATION OF SYMPTOMATIC SIMPLE RENAL CYST: 15-YEAR EXPERIENCE FROM ONE INSTITUTION Kimio Takai, Koji Shiraishi, and Jun Mohri Kimio TakaiKimio Takai Shimonoseki, Yamaguchi, Japan More articles by this author , Koji ShiraishiKoji Shiraishi Ube, Yamaguchi, Japan More articles by this author , and Jun MohriJun Mohri Shimonoseki, Yamaguchi, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1215AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic decortication for renal cyst was first reported in 1992. Although the procedure is well-established, our knowledge about long-term results focused on symptomatic and radiological outcome is limited. METHODS We retrospectively reviewed the records of 46 patients who underwent a total of 46 laparoscopic decortication at our institution between December 1993 and August 2009. Of these cysts, 34 were peripheral and 11 were peripelvic cysts. The patients were asked if they did or did not have pain. Changes of cyst size after decortications were determined by computed tomography (CT) and the serial changes of each cyst were evaluated as percent of preoperative diameter. Relationships between radiological and symptomatic outcome or cyst location were examined. RESULTS Perioperative morbidity was satisfactory. With a mean patient follow-up of 65.0months (range 3 to 128), the symptomatic and radiological success rate were 91% (42 of 46) and 83% (38 of 46), respectively. Peripelvic cyst was significantly correlated with radiological failure. Symptomatic improvement was evident by 3 months, while radiological improvement continued up to 3-4 years postoperatively. Figure shows the serial changes of cyst diameter of each patient after laparoscopic decortication. Thirty-five (76%) cysts were completely diminished during the follow-up periods. Eight cysts (17%) were categorized to radiological failure (thick lines in figure). Twenty-two cysts (48%) disappeared within a year, while 13 cysts (28%) reduced their size up to 48 months. Among the 8 cases of radiological failure, 4 (50%) cases were peripelvic cyst. CONCLUSIONS Laparoscopic decortication is safe procedure that provides long-term satisfactory symptomatic results. Radiological improvement was slower than symptomatic improvement and several cysts remained large, indicating a certain volume reduction was enough to improve the symptoms. This procedure is still challenging for peripelvic cysts in terms of radiological results yet feasible for clinical outcome. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e284 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kimio Takai Shimonoseki, Yamaguchi, Japan More articles by this author Koji Shiraishi Ube, Yamaguchi, Japan More articles by this author Jun Mohri Shimonoseki, Yamaguchi, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...