V1560 TREATMENT OF RENAL HYDATID CYSTS USING A PERCUTANEOUS ENDOSCOPIC APPROACH

Abstract

You have accessJournal of UrologyInfertility, Infection, Erectile Dysfunction & Trauma1 Apr 2011V1560 TREATMENT OF RENAL HYDATID CYSTS USING A PERCUTANEOUS ENDOSCOPIC APPROACH Mohammed lezrek, Khalil Bazine, Abdelghani Ammani, Omar Ghoundale, Mohammed Asseban, Mounir Idrissi, El Hassan Kasmaoui, and Mohammed Alami Mohammed lezrekMohammed lezrek Meknes, Morocco More articles by this author , Khalil BazineKhalil Bazine Meknes, Morocco More articles by this author , Abdelghani AmmaniAbdelghani Ammani Meknes, Morocco More articles by this author , Omar GhoundaleOmar Ghoundale Meknes, Morocco More articles by this author , Mohammed AssebanMohammed Asseban Meknes, Morocco More articles by this author , Mounir IdrissiMounir Idrissi Meknes, Morocco More articles by this author , El Hassan KasmaouiEl Hassan Kasmaoui Meknes, Morocco More articles by this author , and Mohammed AlamiMohammed Alami Meknes, Morocco More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1583AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We present a video of our experience with a percutaneous endoscopic indirect approach to renal hydatid cyst with sterilization, evacuation of the hydatid material, and sclerosis of the cystic cavity. METHODS Since January 2007, 4 patients (2 men and 2 women) presenting renal hydatid cyst were operated by a percutaneous endoscopic approach. The mean age was 36 years (13 to 68). The mean cyst diameter was 15 cm. One cyst has a fistula with the pelvi-caliceal system. After informed consent, all the patients had received 800 mg daily of albendazole chemotherapy during 3 months prior to operation. The patients are placed in the lateral modified position under general anesthesia. After renal opacification, a percutaneous tract, with a 24 Fr Amplatz sheath, is performed through a calyx opposed to the cyst; upper calyx for lower pole cyst and lower calyx for upper pole cyst. Nephroscopy locate the cyst bulge in the caliceal lumen, which is punctured through the nephroscope operating channel using an 18-gauge needle. A 20 % saline solution is used as a scolicidal agent. After tract balloon dilation, the nephroscope is introduced into the cyst, and the hydatid material is aspirated. Then the cystic cavity is filled with contrast media and a drain is inserted through another direct percutaneous access. A nephrostomy tube is inserted in the renal pelvis. Postoperatively, the cystic cavity was treated by instillation of povidone-iodine, after nephrostography documented sealing of the communication between calyx and cystic cavity. RESULTS the percutaneous endoscopic approach and treatment of renal hydatid cysts was possible with a mean operative time of 120 min. The patients had an uneventful discharge and had continued albendazole chemotherapy during 3 months. Nephrostography had documented the sealing of the communication between the calyx and the cystic cavity after 4 days in 3 patients, and after 15 days in the patient presenting the fistula between the cyst and the upper calyx. After a mean follow-up of 33 months (25 to 41) with ultrasound and CT scan, the patients are free of symptoms with no evidence of residual or recurrent disease, with a retracted calcified residual cystic cavity. CONCLUSIONS percutaneous endoscopic approach was effective for the treatment of renal hydatid cysts with lower morbidity than open surgery. We think that via this approach, with the protection of the pelvicaliceal system, Amplatz sheath and saline irrigation, there is less risk of dissemination of hydatid materiel in the retro-peritoneum than with the direct percutaneous access, but only large comparative series will tell. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e626 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohammed lezrek Meknes, Morocco More articles by this author Khalil Bazine Meknes, Morocco More articles by this author Abdelghani Ammani Meknes, Morocco More articles by this author Omar Ghoundale Meknes, Morocco More articles by this author Mohammed Asseban Meknes, Morocco More articles by this author Mounir Idrissi Meknes, Morocco More articles by this author El Hassan Kasmaoui Meknes, Morocco More articles by this author Mohammed Alami Meknes, Morocco More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...