Laparoscopic Cyst Research Articles

Does the Simple Renal Cyst Treatment Improve Renal Function: A Pilot Study.

Background:The current study aims to assess the effects of the large simple renal cyst (SRC) surgery on renal function for the first time.Materials and Methods:This case-series study included 22 patients with larger than 50 mm single SRC who underwent laparoscopic cyst unroofing surgery. Twenty-four-hour urinary protein, creatinine, and volume along with plasma creatinine and estimated glomerular filtration rate (GFR) were measured in patients before and 1 month after surgery. Patients underwent abdominopelvic computed tomography-scan without contrast and parenchymal thickness diameter adjacent to the cyst was measured before and after surgery.Results:Mean age and weight of patients were 52.2 ± 8.9 years and 77 ± 10.9 akg, respectively. There was no significant difference between plasma creatinine and GFR before and after surgery (P = 0.25 and 0.37, respectively). Twenty-four-hour urinary volume, creatinine, and protein before and after surgery revealed no significant changes (P = 0.37, 0.08, and 0.31, respectively). The mean improvement of parenchymal thickness diameter after surgery was 10.4 ± 0.7 mm which was statistically significant (P = 0.001). However, it was not correlated with the mean estimated GFR change (r = 0.349, P = 0.13).Conclusions:Although laparoscopic unroofing of renal cyst recovered renal parenchymal thickness noticeably, it did not improve renal function significantly; therefore, the latter factor lonely should not be considered a reason for surgery decision. Observation can be chosen as a safe treatment strategy in large SRCs without concern about renal function.

Clinical Outcome of Sclerotherapy or Laparoscopic Cyst Excision As Initial Management for Non-parasitic Splenic Cysts in Children

Clinical Outcome of Sclerotherapy or Laparoscopic Cyst Excision As Initial Management for Non-parasitic Splenic Cysts in Children

A Feasible Technique in Laparoscopic Excision for Juvenile Cystic Adenomyosis: A Case Report, Literature Review, and Surgical Video

Background: Juvenile cystic adenomyosis (JCA) is a rare uterine lesion. We present the case of a young woman who was diagnosed with JCA and subsequently managed with laparoscopic cyst removal with sharp and blunt dissection. Moreover, we provide a literature review and a surgical video. Case: A 22-year-old nulliparous woman presented with severe dysmenorrhea and was assessed using contrast-enhanced abdominal computed tomography, transvaginal ultrasonography and pelvic magnetic resonance imaging, and diagnosed with a cystic lesion on the left side of the myometrium. She underwent laparoscopic cyst excision and uterine reconstruction. Histology was suggestive of JCA. The dysmenorrhea resolved postoperatively. Conclusion: Surgical resection is the first choice of treatment for cystic adenomyosis, and a laparoscopic approach using scissor forceps is effective.

Value of Laparoscopic Ovarian Cyst Excision in the Treatment of Ovarian Cysts

Value of Laparoscopic Ovarian Cyst Excision in the Treatment of Ovarian Cysts

Effect of body mass index on the operation time and postoperative hospital stay of retroperitoneal laparoscopic renal cyst decortication

ObjectiveTo investigate the effect of body mass index (BMI) on the operation time and postoperative hospital stay for patients who underwent retroperitoneal laparoscopic decortication for a single simple renal cyst. MethodsA retrospective cohort study was conducted among 81 patients with single simple renal cyst who had undergone retroperitoneal laparoscopic cyst decortication from January 2017 to December 2019 in Wuxi Xishan People's Hospital. All patients were divided into three groups according to BMI: normal group (BMI<25 kg/m2, n = 44), overweight group (BMI = 25–30 kg/m2, n = 21), and obese group (BMI>30 kg/m2, n = 16). Multiple linear regression was conducted to investigate the correlation. ResultsThe three groups were comparable in terms of age, gender, maximum diameter of cyst, and cyst location. In the aspect of operation time, only the patients in obese group had longer duration when compared with those in the normal group (59.1 ± 15.7 min vs. 45.2 ± 12.8 min, p = 0.001). And the patients in the obese group had significantly longer hospital stay compared with those in the normal group (6.2 ± 1.9 d vs. 5.2 ± 0.5 d, p = 0.002) and overweight group (6.2 ± 1.9 d vs. 5.0 ± 1.0 d, p = 0.001). In the analysis of multiple linear regression, it was found that operation time is significantly affected by BMI and location 2, with coefficients of 1.299 and −8.646 respectively. The influence of BMI was greater than location 2 (0.335 vs. −0.289). For hospital stay, only BMI had an effect on it, with a coefficient of 0.110. ConclusionBMI was a major factor that associated with longer operation time and hospital stay in patients with retroperitoneal laparoscopic renal cyst decortication.

6-Year-Old Girl With a Luteinized Follicular Ovarian Cyst and an Estradiol Level &amp;gt; 1,000 PG/ML

Background: Precocious puberty in girls is defined as onset of secondary sexual characteristics, such as breast development, before 8 years of age. To differentiate between central and peripheral precocious puberty, laboratory and imaging evaluation is helpful. When gonadotropins are low but estradiol is elevated, results may suggest a primary ovarian source of estrogen production. Small ovarian cysts are not uncommon, are benign and self-resolve. However, large ovarian cysts are rare, let alone ones requiring surgical removal. Clinical Case: A 6 year 7 month old girl presented with several days of breast tenderness and palpable bilateral breast tissue noted by her mother. There was no history of vaginal bleeding. There were no reported exposures to estrogen-containing products. Her mother reached menarche at age 14 years. The patient was born full term and was otherwise healthy. On exam, her height was at the 90-95th %ile (mid-parental height at the 95th %ile) and her growth velocity was 10.9 cm/yr. She had Tanner 2 breasts (1 cm breast bud on the left and 1.5 cm on the right), Tanner 1 pubic hair and no axillary hair, body odor, acne or café-au-lait macules. A bone age was read as 6 years at a chronological age of 6 years 7 months. A laboratory evaluation revealed an estradiol of 1,029 pg/mL (<15 pg/mL), LH <0.02 mIU/mL, FSH <0.09 mIU/mL, 17-hydroxyprogesterone (17-OHP) 410 ng/dL (<91 ng/dL), AFP 2.3 ng/mL (<6.1 ng/mL), beta-hCG <2 mIU/mL, TSH 2.41 mIU/L (0.5-3.2 mIU/L), and free T4 0.9 ng/dL (0.9-1.4 ng/dL). Pelvic ultrasound revealed a large unilocular cystic structure measuring 6.5 x 4.1 x 6.1 cm in the left adnexal region with no left ovary visualized. The right ovary appeared prepubertal. The uterus was prepubertal in appearance with endometrial thickness of 2 mm. Abdominal ultrasound showed no evidence of a suprarenal mass. A laparoscopic cyst resection was completed, given the risk of left ovarian torsion. Cytology was negative; pathology revealed a luteinized follicular cyst. Repeat labs in one month showed a prepubertal estradiol level of 6.7 pg/mL with LH 0.02 mIU/mL and FSH 0.38 mIU/mL. 17-OHP normalized to 29 ng/dL. Breast tissue had regressed. Conclusion: This case describes the rare finding of a large luteinized follicular ovarian cyst that required surgical removal in a 6-year-old girl in the setting of a significantly elevated estradiol level. Luteinized follicular cysts have been described in newborns, though rare. To our knowledge, this is the first described case of a luteinized follicular cyst in this patient’s age group. Laboratory and imaging evaluation should be considered in girls presenting with precocious puberty, despite the extent of thelarche, as the clinical examination does not always correlate with degree of estradiol elevation. This is especially important if clinical changes are acute and other features are consistent with puberty, such as rapid linear growth.

Hemorrhagic abdominal pseudocyst following ventriculoperitoneal shunt: a case report

BackgroundAbdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon but important complication of ventriculoperitoneal (VP) shunts. While individual articles have reported many cases of abdominal CSF pseudocyst following VP shunts, no case of a hemorrhagic abdominal pseudocyst after VP shunts has been reported so far.Case presentationThis article reports a 68-year-old woman with a 4-month history of progressive abdominal pain and distention. She denied any additional symptoms. A VP shunt was performed 15 years earlier to treat idiopathic normal pressure hydrocephalus and no other abdominal surgery was performed. Physical examination revealed an elastic palpable mass in her right lower abdomen, which was dull to percussion. Abdominal computed tomography (CT) scan indicated a large cystic collection of homogenous iso-density fluid in the right lower abdominal region with clear margins. The distal segment of the peritoneal shunt catheter was located within the cystic mass. Abdominal CSF pseudocyst was highly suspected as a diagnosis. Laparoscopic cyst drainage with removal of the whole cystic mass was performed, 15-cm cyst which found with thick walls and organized chronic hematic content. No responsible vessel for the cyst hemorrhage was identified. No further shunt revision was placed. Histological examination showed that the cyst wall consisted of outer fibrous tissue and inner granulation tissue without epithelial lining, and the cystic content was chronic hematoma. The patient had an uneventful postoperative course and remained asymptomatic for 8-mo follow-up.ConclusionTo the best of our knowledge, this is the first report of hemorrhagic onset in the abdominal pseudocyst following VP shunt. Such special condition can accelerate the appearance of clinical signs of the abdominal pseudocyst after VP shunts, and its mechanisms may be similar to the evolution of subdural effusion into chronic subdural hematoma (CSDH).

Evaluation of renal cyst treatment using retroperitoneal laparoscopic decortication

Introduction: Renal cyst is a common disease of the renal parenchyma. The management options include percutaneous aspiration with or without sclerotherapy, open surgery, and laparoscopic decortication of renal cyst. Laparoscopic renal cyst decortication is a safe and effective alternative with a high success rate. Objectives: Evaluation of renal cyst treatment by retroperitoneal laparoscopic decortication.&#x0D; Methods: This was a prospective study of patients with asymptomatic renal cyst size greater than 60 mm or symptomatic renal cyst size less than 60 mm in their greatest dimension. These patients underwent retroperitoneal laparoscopic decortication and were admitted at the University Hospital, Can Tho General Hospital (Viet Nam), and Can Tho Central General Hospital (Viet Nam), from September 2018 to May 2020. Renal cysts were localized and characterized by ultrasonography and computed tomography (CT). Symptomatic success rate, radiologic success rate, and complication of procedure were noted. Each patient was reassessed with clinical and ultrasonography examinations at 3 months postoperatively.&#x0D; Results: 33 patients underwent retroperitoneal laparoscopic cyst decortication; this included 11 males (33.3%) and 22 females (66.7%). The mean age of patients was 58.48 ± 9.36 years. Flank pain was a common clinical symptom at presentation in all patients. Most of the cysts were located in the left kidney (39.4%), in the lower pole (54.6%), and in a single cyst (87.9%). The mean cyst diameter was 80.09 ± 27.03 mm. Cysts were classified I with the Bosniak classification. The mean operative time was 69.39 ± 16.94 minutes. Operative time in patients with cyst diameter ≥ 60 mm was statistically significantly longer than in patients with cyst diameter &lt; 60 mm (p = 0.004). The mean hospital stay time was 8.24 ± 2.84 days. Symptomatic success was achieved in 90.1% of patients and radiographic success on ultrasonography was achieved in 84.8%. The operation was successfully completed by laparoscopy in all cases.&#x0D; Conclusion: Retroperitoneal laparoscopic cyst decortication is effective for the treatment of renal cysts. The operation was successfully completed via laparoscopy in all cases.

Laparoscopic Type IV Choledochal Cyst Excision with Roux-En-Y Hepaticojejunostomy

Introduction: Choledochаl cysts represent а rare congenital cystic dilation of the biliary tract. Nearly 25% are diagnosed in the first year of life with and incidence of approximately 1/200 000 live births in western countries, although these numbers are significantly higher in East Аsiаn populations. Presentation typically occurs in childhood, with jaundice, fever or an abdominal mass. Although benign, choledochаl cysts cаn be аssociаted with various complications including malignant transformation. In western countries, the incidence of cholangiocarcinoma has been reported to reach 12% in some series, with higher reports in Asian countries. Other hurdles include cholangitis, pancreatitis, and cholelithiаsis. The modified Todani classification is employed to describe the various types of choledocal cysts (I-V). Type I, a fusiform dilation of the common bile duct, is the most common. Type IV is the second most prevalent, with extension of the cysts into the intrahepatic ducts. Types II, II and V are less frequent. This video intends to present the laparoscopic excision of a type IV choledocal cyst with intracorporeal Roux-en-Y hepaticojejunostomy with a specific attention on technical detail and education. Methods: A 49 year old female with no relevant prior medical history presented with a history of abdominal comfort. Results: An abdominal CT scan showed common biliary duct dilation and an MRi revealed the existence of a type IVa choledochаl cyst. Laparoscopic cyst excision was proposed and accepted. The patient was submitted to surgery on January 2021, initiated oral intake on day 2 and was discharged at day 7 without any hurdles. Conclusion: Laparoscopic choledochal cyst excision is a safe procedure with decreased morbidity and in-hospital stay days compared with an open approach. The authors consider that the video quality and surgical procedure can successfully contribute to the education and training of surgery residents and also contribute to share expertise and consolidate knowledge to surgeons.

Renal calyceal diverticulum mimicking a large renal cyst-A case report

Renal calyceal diverticulum are outpouching from renal calyx or pelvis into the renal cortex lined by transitional cell epithelium. We report a case of 35 years old male with history of accidental fall from bike, who presented with persistent right loin pain and hematuria. CT Urogram showed multiple large right renal cysts (BOSNIAK II). Patient was planned laparoscopic renal cyst deroofing. Due to suspicion of calyceal diverticulum, an intraoperative Retrograde Pyelogram (RGP) was done which showed calyceal diverticulum. Laparoscopic calyceal diverticulotomy with closure of communication was done. If only a cyst deroofing was done considering the CT finding alone, it would have ended up in post-operative complication of urinoma which may require a re-surgery. This case report emphasizes the importance of anticipating calyceal diverticulum and intraoperative attempts in the form of doing RGP to identify calyceal diverticulum which mimic renal cyst regardless of CT finding in suspected cases.&#x0D; Keywords: Calyceal diverticulum; large renal cyst; retrograde pyelogram; laparoscopic calyceal; Diverticulotomy.

The preliminary experience of methylene blue assisted laparoscopy in the treatment of renal parapelvic cysts

Renal cyst is a common disease in humans and laparoscopic renal cyst decortication is the gold standard for treatment. However, specialized surgical skills are required for the treatment of renal parapelvic cysts. In this study, we describe an improved laparoscopic method for the treatment of renal parapelvic cysts involving the use of continuous infusion of methylene blue. Sixteen patients with renal parapelvic cyst were enrolled in this study. All patients underwent retrograde ureteral catheterization, with continuous perfusion of the renal pelvis using a solution of 0.2% methylene blue and saline, during laparoscopic decortication of the parapelvic cyst. In one patient, the cyst communicated with the renal collection system which was injured, but this was immediately repaired intraoperatively. All operations were successful, and none was converted to open surgery. There were no occurrences of persistent urinary fistula, bleeding, or other complications postoperatively. All patients were followed-up for 3–24 months, and results of postoperative imaging investigations revealed that all of our patients experienced either complete recovery or a greater than 50% decrease in size of the cysts. Our study demonstrates that methylene blue-assisted laparoscopic treatment is a safe, effective and practical method for the treatment of renal parapelvic cysts.

Preventive therapeutic options for postoperative recurrence of ovarian endometrioma: gonadotropin-releasing hormone agonist with or without levonorgestrel intrauterine system insertion.

Here, we compared endometrioma recurrence rates in patients who have undergone a laparoscopic cystectomy and treated with a gonadotropin-releasing hormone agonist (GnRHa) alone or a GnRHa combined with a levonogestrel intrauterine system (LND-IUS). We enrolled endometrioma patients who underwent laparoscopic cyst enucleation and divided them into two groups according to postoperative management: GnRHa alone and GnRHa in combination with LND-IUS. We compared preoperative history, perioperative parameters, postoperative endometrioma recurrence, and symptoms between these two groups. A total of 320 patients were included in the final analysis. With a median 84.6months of follow-up, we detected significant differences between the two groups with respect to age at surgery (31.6 ± 4.8 vs. 37.6 ± 4.2years, χ2 = 1.978, p < 0.001), gravida (0 vs. 2, χ2 = 4.391, p < 0.001), parity (0 vs. 1, χ2 = 0.035, p < 0.001), body mass index (21.0 ± 2.5 vs. 21.9 ± 2.4, χ2 = 0.0096, p = 0.009), r-AFS score (48 vs. 64, χ2 = 4.888, p = 0.001), and operation time (60 vs. 75min, χ2 = 9.119, p = 0.003). Patients treated with both GnRHa and LND-IUS achieved significantly less endometrioma recurrence (23.6 vs. 11.5%, χ2 = 5.202, p = 0.023) and higher rates of pain remission (92.1 vs. 100%, χ2 = 6.511, p = 0.011), while those with GnRHa alone suffered more recurrent and painful symptoms (χ2 = 9.280, p = 0.026). Multivariate analysis using a Cox regression demonstrated that combined GnRHa and LNG-IUS treatment correlated with a decreased endometrioma recurrence rate after laparoscopic cystectomy (RR 0.369, 95% CI 0.182-0.749, p = 0.006). Combination treatment of GnRHa and LNG-IUS exhibited superior pain relief and recurrence prevention among endometrioma patients after fertility-sparing surgery. Thus, combination treatment is a preferable long-term option for patients without intent for pregnancy in the near future.

Total versus conventional laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy in children with choledochal cysts: a case\u2013control study

BackgroundTo compare the efficacy of total and conventional laparoscopic hepaticojejunostomy (TLH and CLH) in children with choledochal cysts (CDCs).MethodsData from patients undergoing TLH and CLH between August 2017 and December 2018 were retrospectively analyzed. Intraoperative blood loss, time for jejunum-cojejunum anastomosis, time to oral intake, postoperative hospital stay, hospitalization expenses, and postoperative complications were compared.ResultsAll 55 patients (TLH = 30, CLH = 25) were successfully treated without conversion to open surgery. In the TLH and CLH groups, the time to oral intake was 3.57 ± 0.19 d and 4.56 ± 0.27 d, respectively (t = 3.07, P < 0.01), the postoperative hospital stay was 5.50 ± 0.28 d and 7.00 ± 0.74 d (t = 2.03, P < 0.05), and the hospitalization expenses were CNY 40,085 ± 2447 and CNY 26,084 ± 2776 (t = 3.79, P < 0.001). There were no significant differences in intraoperative blood loss (9.57 ± 3.28 ml vs 8.2 ± 1.13 ml, t = 0.37, P = 0.72) or time for jejunum-cojejunum anastomosis (80.5 ± 2.46 min vs 75.00 ± 2.04 min, t = 1.68, P = 0.10). The median follow-up periods of the TLH and CLH groups were 17 and 16 months, respectively. Overall complication rates were comparable between the two groups (10% vs 8%, χ2 = 0.07, P = 0.79).ConclusionsTLH in children with CDCs has the advantages of rapid gastrointestinal functional recovery and a short hospitalization. However, hospitalization is relatively expensive.

Is the laparoscopic choledochal cyst excision and Roux-En-Y hepaticojejunostomy in adults as safe as that in children?

АbstrаctBаckgrоundLaparoscopic cyst excision and Roux-en-Y hepaticojejunostomy for treating congenital choledochal cysts has been proven to be efficacious in children, but its safety and efficacy in adult patients remain uncertain. This study aims to investigate the safety and effectiveness of laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy in adults compared to those in children patients.ResultsThere was no conversion to open surgery in both groups. The mean operative time and hospital duration stay in adults (253.4 min and 11.7 days, respectively) were longer in than those in children (214.7 min and 9.3 days, respectively). Intrаоperаtive blооd trаnsfusiоn wаs required in one adult and twо children. There was not reoperation due to bile leakage in adults compared to those in 2 children. The time frоm surgery tо drаinаge remоvаl wаs longer in adults (3.6 vs. 2.9 days). The outcome within three months of discharge was classified as good in 88.2 % of adults and 90.5% for children. There were nо stаtisticаlly significаnt differences in eаrly pоstоperаtive cоmplicаtiоns оr treаtment оutcоmes between the twо grоups.CоnclusiоnsLаpаrоscоpic chоledоchаl cyst excisiоn fоllоwed by Rоux-en-Y hepаticоjejunоstоmy wаs sаfe аnd efficient in bоth аdults аnd children. Оperаtive time wаs lоnger in аdults thаn in children.

Type VI Choledochal Cyst; A Case Report and Review of the Literature

BackgroundCholedochal or common bile duct (CBD) cysts are congenital cystic dilatation of any part of the bile ducts. It has been classified into five main types by Todani et al. Isolated cystic duct cysts are not included in this classification. It is extremely rare, and there are a limited number of cases in the literature.Case presentationA 34-year-old male patient was admitted to our hospital with right upper quadrant (RUQ) pain experienced intermittently for the past year. His medical history and laboratory findings were normal. Physical examination revealed tenderness in the RUQ. Abdominal ultrasonography shows that a thin, tubular, cystic lesion was associated with the CBD. On magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP), a saccular dilatation was observed in the middle part of the cystic duct. Isolated cystic duct dilatation was considered with current imaging findings. Laparoscopic cholecystectomy and cyst excision were performed. Surgery findings and histopathological examination of the excised cyst confirmed the diagnosis.ConclusionIsolated dilatations of the cystic duct are extremely rare, and familiarity with this anatomic variation and its early diagnosis can prevent complications such as inflammation and malignancy and guide the surgery. The most effective noninvasive imaging method in diagnosis is MRCP. Also, we recommend that it be classified as a new type with the name type VI biliary cyst, in addition to Todani classification.

Large Symptomatic Presacral Epidermoid Cyst: Laparoscopic Transabdominal Cyst Resection Technique

One of the unusual etiologies of lower back pain is an epidermoid cyst which is a rare tumor of presacral space. We present a 50-year-old female who came to our clinic complaining of lower back pain with chronic constipation for 20 years. A CT-scan was done and showed a presacral cyst proceeded by an MRI that appeared to be a thin wall presacral/retrorectal cyst compressing the uterus and the urinary bladder and more in the left side of the rectum, hypointense in T1 signals and hyperintense in T2 signals. Because of the size and the site of the tumor, laparoscopic transabdominal presacral cyst resection was performed. The histopathological examination diagnosed the specimen as an epidermoid cyst. Thereby, a proper diagnosis and the management plan are important in such presacral cysts to prevent their complications like infection, bleeding, and malignant degeneration.

Renal Parenchymal Volumetric Expansion Assessed by CT Imaging After Laparoscopic Cyst Decortication.

To delineate the expansion of the renal parenchyma using volumetric CT imaging before and after the laparoscopic cyst decortication procedure and to determine the possible associations between parenchymal expansion and laboratory parameters and cyst volume. Thirty-five patients that underwent laparoscopic cyst decortication were included in this prospective study. Abdominal contrast-enhanced CT was performed in all patients in the preoperative and postoperative period. Semi-automatic volume quantification was undertaken offline, and renal parenchymal volumes before and after cyst decortication, as well as serum creatinine and estimated glomerular filtration rate (eGFR) were compared. The changes in serum creatinine and eGFR in the postoperative period were non-significant. The mean postoperative renal parenchymal volumes were higher compared to the preoperative measurements for both observations (P = .014 and .034 for the first and second measurements, respectively). There was no correlation between the volumetric change and the cyst volume (r = -0.18, P = .560). In patients undergoing laparoscopic cyst decortication, post-operative parenchymal expansion can be detected using volumetric CT imaging to confirm the immediate benefits of the procedure.

Meta-analysis of Laparoscopic cyst decortication versus traditional open cyst decortication for ADPKD in China: evidence based on 362 cases and 399 controls

Meta-analysis of Laparoscopic cyst decortication versus traditional open cyst decortication for ADPKD in China: evidence based on 362 cases and 399 controls

Endothelin-1 Level in Patients with Simple Renal Cyst.

Endothelin-1 (ET-1) is potent vasoconstrictive peptide and elevated ET-1 levels are associated with hypertension, endothelial dysfunction and atherosclerosis. Research on (ET-1) has demonstrated that elevated ET-1 levels in autosomal dominant polycystic kidney disease leads to systemic hypertension. The prevalence of simple renal cysts increases with age and the association with simple renal cyst and hypertension is not clear. The aim of this study was to investigate the ET-1 levels in patients with simple renal cyst and compare them with those in healthy adults. The study included patients that underwent laparoscopic renal cyst decortication in the Department of Urology and healthy controls. Serum and urinary ET-1 levels were measured before surgery and one month after it in the patients with simple renal cyst. Serum ET-1 levels were measured in healthy adult patients. Ambulatory blood pressure was measured in all patients. Glomerular filtration rate was measured according to the chronic kidney disease epidemiology collaboration formula. Thirty-two patients were included in the present study. Of these, 16 patients with simple renal cyst were allocated into group 1 and 16 healthy patients - in group 2. There was no significant difference between systolic and diastolic blood pressure between the groups (. The present study demonstrated that serum EL-1 level in patients with simple renal cyst was lower than that in healthy people. Further studies are needed to investigate the EL-1 levels in simple renal cyst patients.

Cross-sectional imaging and laparoscopic findings of diaphragmatic mesothelial cysts

To present cross-sectional imaging, surgical findings, and follow-up results of diaphragmatic mesothelial cysts. Radiological findings for location, size, shape, and internal structure of cysts were reviewed retrospectively. For patients that underwent surgery, surgical reports and laparoscopy images were reviewed. In conservatively managed patients, changes in size and imaging findings of the cyst were assessed during follow-up visits. A total of 13 paediatric cases with an imaging and/or pathological diagnosis of diaphragmatic mesothelial cyst were identified. In all cases, the cystic lesions were located between the diaphragm and the posterolateral aspect of the right lobe of the liver. Eleven lesions (84.6%) had a bi-lobulate shape. Eight of these cases underwent laparoscopic cyst aspiration/unroofing. The postoperative course was uneventful and there were no cases of recurrence. The remaining five cases were managed conservatively with follow-up available in four cases. In three cases (75%), there was reduction in the size of the cysts with a mean volume reduction of 55%. Diaphragmatic mesothelial cysts are congenital cystic lesions that are usually detected incidentally. A common pitfall is incorrect interpretation of the lesion as a hepatic cyst. Conservative management with imaging follow-up can be adopted in asymptomatic cases with typical imaging findings.