Prevention of recurrence of simple renal cyst after retroperitoneal laparoscopic decortication

Abstract

Objective To investigate the effective method of reducing the recurrence of renal cyst after retroperitoneal laparoscopic decortication. Methods The clinical and follow-up data of 328 cases of patients with simple renal cyst underwent retroperitoneal laparoscopic renal cyst decompression from January 2014 to March 2016 in our hospital were analyzed retrospectively. One hundred and five patients had a simple decortication (control group, n=105). The remaining 223 patients had a decortication with different intervention method to prevent recurrence, including 60 cases with anhydrous ethanol sclerotherapy (sclerotherapy group, n=60), 78 cases with wadding of the cyst using perirenal fat tissue (fat wadding group, n=78 ) and 85 cases with evaginated and fixed the cyst wall by titanium clips (titanium clips fixed group, n=85). The operation time, intraoperative blood loss, postoperative complications, postoperative hospital stay and recurrence rate after 1 year were compared. Results Compared with the control group, all the 3 intervention methods (sclerotherapy group, fat wadding group and titanium clips fixed) significantly decreased the 1 year recurrence rate (5%, 3.8%, 4.7% vs. 13.3%, F=8.319, P=0.040). However, the operation time [(40.7±12.6)min vs. (30.5±10.2)min, t=5.664, P 0.05). Conclusions Combined with wadding of the cyst using perirenal fat tissue or evaginated and fixed the cyst wall by titanium clips in the retroperitoneal laparoscopic decortication is a safe and effective method to reduce postoperative recurrence. The anhydrous ethanol sclerotherapy may be an inappropriate choice due to increased operation time and complications. Key words: Kidney Diseases; Cysts; Laparoscopes; Decompression, Surgical