Purpose: 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.
Materials and Methods: 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.
Results: 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).
Conclusion: 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.
Hulbert JC, Shepard TG, Evans RE. Laparoscopic surgery for renal cystic disease. J Urol. 1992;147,433A.
Abbaszadeh S, Taheri S, Nourbala MH. Laparoscopic decortication of symptomatic renal cysts: experience from a referral center in Iran. Int J Urol. 2008;15:486-9.
Shiraishi K, Eguchi S, Mohri J. Laparoscopic decortication of symptomatic simple renal cysts: 10-year experience from one institution. BJU Int. 2006;98:405-8.
King BF, Reed JE, Bergstralh EJ. Quantification and longitudinal trends of kidney, renal cyst, and renal parenchyma volumes in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 2000;11:1505-11.
Houbois C, Haneder S, Merkt M. Can computed tomography volumetry of the renal cortex replace MAG3-scintigraphy in all patients for determining split renal function?. Eur J Radiol. 2018;103:105-111.
Singh I, Strandho JW, Assimos DG. Upper Urinary Tract Obstruction and Trauma. In: Wein AJ, Kavoussi LR, Novick AC, eds. Campbell-Walsh Urology (10th edition). Philadelphia: Elsevier Saunders;2009: 2;40:1087–1121.
Coll DM, Herts BR, Davros WJ. Preoperative use of 3D volume rendering to demonstrate renal tumors and renal anatomy. Radiographics. 2000;20:431-8.
Hemal AK. Laparoscopic management of renal cystic disease. Urol Clin North Am. 2001;28:115-26.
Rane A. Laparoscopic management of symptomatic simple renal cysts. Int Urol Nephrol. 2004;36:5-9.
Skolarikos A, Laguna MP, de la Rosette JJ. Conservative and radiological management of simple renal cysts: a comprehensive review. BJU Int. 2012;110:170-8.
Laucks SP Jr, McLachlan M. Aging and simple cysts of the kidney. Br J Radiol. 1981;54: 12-4.
Tadayon A, Ayanifard M, Mansoori D. Endoscopic Renal Cyst ablation. Urol. J. 2004;1: 170-3.
Pope JC. Renal Dysgenesis and Cystic Disease of the Kidney. In: Wein AJ, Kavoussi LR, Novick AC, eds. Campbell-Walsh Urology (10th edition). Philadelphia: Elsevier Saunders;2012;4, 118:3161–3196.
Atug F, Burgess SV, Ruiz-Deya G. Long-term durability of laparoscopic decortication of symptomatic renal cysts. Urology. 2006;68:272-5.
Holmberg G, Hictala SO. Treatment of simple renal cysts by percutaneous puncture and instillation of bismuthphosphate. Scand J Urol Nephrol. 1989;23:207-12.
Hanna RM, Dahniya MH. Aspiration and sclerotherapy of symptomatic simple renal cysts: value of two injections of a sclerosing agent. AJR Am J Roentgenol. 1996;167:781-3.
Okeke AA, Mitchelmore AE, Keeley FX. A comparison of aspiration and sclerotherapy with laparoscopic deroofing in the management of symptomatic simple renal cysts. BJU Int. 2003; 92:610-3.
A. Taylor, J.V. Nally. Review article clinical of renal scintigraphy. Am. J. Roentgenol. 1995;164:31-41.
Keramida G, James JM, Prescott MC. Pitfalls and Limitations of Radionuclide Renal Imaging in Adults. Semin Nucl Med. 2015;45:428-39.
Lee DI, Andreoni CR, Rehman J. Laparoscopic cyst decortication in autosomal dominant polycystic kidney disease: impact on pain, hypertension, and renal function. J Endourol. 2003;17:345-54.
Teichman JM, Hulbert JC. Laparoscopic marsupialization of the painful polycystic kidney. J Urol. 1995;153:1105-7.
Marte A, Pintozzi L. Laparoscopic treatment of symptomatic simple renal cysts in children: single-center experience. Pediatr Med Chir. 2018;24:40-1.
Hackstein N, Buch T, Rau WS. Split renal function measured by triphasic helical CT. Eur J Radiol. 2007;61:303-9.
Summerlin AL, Lockhart ME, Strang AM. Determination of split renal function by 3D reconstruction of CT angiograms: a comparison with gamma camera renography. AJR Am J Roentgenol. 2008;191:1552-8.
Cheung CM, Shurrab AE, Buckley DL. MR-derived renal morphology and renal function in patients with atherosclerotic renovascular disease. Kidney Int. 2006;69:715-22.