A Prospective Evaluation of Laparoscopic Management of Renal Hydatidosis: Our Experience

Abstract

Introduction: Hydatid cyst is a parasitic disease affecting various organs like liver, lungs, spleen or rarely kidneys, caused by the tapeworm Echinococcus granulosus. Its presentation may be atypical leading to diagnostic and management difficulties. A high index of suspicion for hydatid disease should be maintained while evaluating complex cystic renal masses. Accurate diagnosis of primary renal hydatid disease is difficult in spite of latest imaging modalities. With the technological advancements and increasing experience in laparoscopy, nowadays renal hydatid disease has been reported to be managed by transperitoneal and retroperitoneal laparoscopic approach. Objective/Aim: To present a prospective evaluation of renal hydatidosis managed laparoscopically. Material Methods: All 22 consecutive patients underwent laparoscopic management of renal hydatid disease from August 2019 to July 2021. Prior to surgery all patients were preoperatively evaluated with CT urography. All patients were operated with total laparoscopic transperitoneal route by standard three ports as for renal surgery. Patients demographic and perioperative data were recorded prospectively and analysed. Outcome measures were demographic data, perioperative data, complications and follow-up at 12 months. Results: The mean operative time was 190.3 minutes and average blood loss was 180.4 ml in our study. There were 4 cases converted to open method in our study. There were 7 cases managed with cyst excision, 3 cases managed with cyst deroofing and marsupilisation, 9 cases required pericystectomy and 3 cases required nephrectomy as there was no salvageable parenchyma in our study. Conclusion: Laparoscopic treatment of renal hydatid cyst is safe, feasible and effective due to its advantages to open surgery, if surgical expertise is available. It can minimize morbidity, as surgery is the treatment of choice.