Minimally Invasive Surgeries in the Management of Renal Parapelvic Cysts: A Retrospective Comparative Study laparoscopy and ureterorenoscopy in renal parapelvic cyst
Urology Journal,
Vol. 18 No. 04 (2021),
20 September 2021
,
Page 389-394
https://doi.org/10.22037/uj.v18i04.6466
Abstract
Purpose: To compare the efficiency and safety of two minimally invasive surgeries, laparoscopy and flexible
ureteroscopy (fURS), in the management of renal parapelvic cysts.
Materials and Methods: Between January 2013 and April 2019, patients who suffered from parapelvic cysts and
received fURS or laparoscopy at our hospital were recruited for this study. All patients underwent biopsies of the cyst wall. Primary outcome was treatment success, which was defined as symptomatic and radiological. During follow-up, telephone contact and CT scans were used to record any relevant symptoms and any recurrence, respectively.
Results: A total of 33 patients (22 in fURS; 11 in laparoscopy) were included in this study. Flank pain prior to the
procedures were reported by 14/22 patients and 6/11 in fURS and laparoscopy, respectively (P = .62), and patients had complete pain relief after the operation. The complication rate was significantly lower in the fURS group than in the laparoscopy group (P = .01). Minor complications were observed in 3/22 and 5/11 patients (Grade 1 and 2) in the fURS and laparoscopy group, respectively. All patients were controlled by conservative treatment. However, 1/11 major complication (Grade 3b) was detected in the laparoscopy group and managed by ureteroscopy to remove the obstruction under general anesthesia. Significant differences were found in operative time (P = .01) and postoperative hospital stay (P = .01), while medical expenses were similar between the two groups (P = .42). During follow-up, no recurrence was detected in CT scans.
Conclusion: In the management of parapelvic cysts, two minimally invasive surgeries were comparable in efficiency. However, fURS was superior to laparoscopic unroofing with regard to the complication rate, operative time, and postoperative hospital stay.
- comparative; laparoscopy; parapelvic cyst; ureterorenoscopy
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References
2. Zhao Q, Huang S, Li Q, et al. Treatment of Parapelvic Cyst by Internal Drainage Technology Using Ureteroscope and Holmium Laser. West Indian Med J. 2015;64.
3. Choi HS, Kim CS, Bae EH, Ma SK, Kim SW. Bilateral Parapelvic Cyst Misdiagnosed as Hydronephrosis. Chonnam medical journal. 2019;55:65-.
4. Rossi SH, Koo B, Riddick A, Shah N, Stewart GD. Different successful management strategies for obstructing renal parapelvic cysts. Urologia internationalis. 2018;101:366-8.
5. Agarwal M, Agrawal MS, Mittal R, Sachan V. A randomized study of aspiration and sclerotherapy versus laparoscopic deroofing in management of symptomatic simple renal cysts. J Endourol. 2012;26:561-5.
6. Eissa A, El Sherbiny A, Martorana E, et al. Non-conservative management of simple renal cysts in adults: a comprehensive review of literature. Minerva urologica e nefrologica = The Italian journal of urology and nephrology. 2018;70:179-92.
7. Wang Z, Zeng X, Chen C, Wang T, Chen R, Liu J. Methylene Blue Injection via Percutaneous Renal Cyst Puncture Used in Flexible Ureteroscope for Treatment of Parapelvic Cysts: A Modified Method for Easily Locating Cystic Wall. Urology. 2018.
8. Yu W, Zhang D, He X, et al. Flexible ureteroscopic management of symptomatic renal cystic diseases. The Journal of surgical research. 2015;196:118-23.
9. Chen Z, Chen X, Luo YC, He Y, Li NN, Wu ZH. Retroperitoneoscopic decortication of symptomatic peripelvic renal cysts: Chinese experience. Urology. 2011;78:803-7.
10. Liu T, Peng Y, Jia C, Fang X, Li J, Zhong W. Hepatocyte growth factor-modified adipose tissue-derived stem cells improve erectile function in streptozotocin-induced diabetic rats. Growth Factors. 2015;33:282-9.
11. Yu W, Zhang D, He X, et al. Flexible ureteroscopic management of symptomatic renal cystic diseases. J Surg Res. 2015;196:118-23.
12. Wang Z, Zeng X, Chen C, Wang T, Chen R, Liu J. Methylene Blue Injection via Percutaneous Renal Cyst Puncture Used in Flexible Ureteroscope for Treatment of Parapelvic Cysts: A Modified Method for Easily Locating Cystic Wall. Urology. 2019;125:243-7.
13. Shao Z-Q, Guo F-F, Yang W-Y, et al. Percutaneous intrarenal marsupialization of symptomatic peripelvic renal cysts: a single-centre experience in China. Scandinavian journal of urology. 2013;47:118-21.
14. Shah JB, Whitman C, Lee M, Gupta M. Water under the bridge: 5-year outcomes after percutaneous ablation of obstructing parapelvic renal cysts. Journal of Endourology. 2007;21:1167-70.
15. Roberts WW, Bluebond-Langner R, Boyle KE, Jarrett TW, Kavoussi LR. Laparoscopic ablation of symptomatic parenchymal and peripelvic renal cysts. Urology. 2001;58:165-9.
16. Micali S, Pini G, Sighinolfi MC, De Stefani S, Annino F, Bianchi G. Laparoscopic simultaneous treatment of peripelvic renal cysts and stones: case series. J Endourol. 2009;23:1851-6.
17. Mao X, Xu G, Wu H, Xiao J. Ureteroscopic management of asymptomatic and symptomatic simple parapelvic renal cysts. BMC Urol. 2015;15:48.
18. Luo Q, Zhang X, Chen H, et al. Treatment of renal parapelvic cysts with a flexible ureteroscope. Int Urol Nephrol. 2014;46:1903-8.
19. Doumas K, Skrepetis K, Lykourinas M. Laparoscopic ablation of symptomatic peripelvic renal cysts. J Endourol. 2004;18:45-8.
20. Camargo A, Cooperberg MR, Ershoff BD, Rubenstein JN, Meng MV, Stoller ML. Laparoscopic management of peripelvic renal cysts: University of California, San Francisco, experience and review of literature. Urology. 2005;65:882-7.
21. Basiri A, Hosseini SR, Tousi VN, Sichani MM. Ureteroscopic management of symptomatic, simple parapelvic renal cyst. J Endourol. 2010;24:537-40.
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