Long-term results of surgical treatment of solitary kidney cysts

Cover Page

Cite item

Full Text

Abstract

Introduction. Simple kidney cyst is a common disease that may need surgical treatment for pain, hypertension and kidney obstruction. Long term results of kidney cyst treatment need further investigation.

The aim of the study was to assess patient complaints and kidney ultrasound sonography data in patients in a long term after percutaneous cyst aspiration (PCA) with sclerotherapy and laparoscopic decortications of the cyst wall (LDC).

Patients and methods. In this retrospective study clinical data of 891 patients (277 (31,1%) men and 614 (68,9%) women, mean age 61,8 years) with simple kidney cysts operated by PCA and LDC (754 (84,6%) and 137 (15,4%) patients respectively) due to back pain, hypertension, big cyst size and obstruction of urine flow from the kidney was analyzed. Control survey and ultrasound sonography scans were performed in 80 (18,1%) patients, including 40 (50%) patients after PCA and 40 (50%) patients after LDC.

Results. At control sonography kidney cysts were found in 32(80%) and 27(68%) patients after PCA and LDC respectively, but median cyst size decreased. Compared to PCA, LCD more often resulted in complete disappearance of cysts and also caused more prominent cyst size reduction (p = 0,027), however the lengths of stay (LOS) was longer after LDC (p = 0,005). After surgery the back pain and hypertension persisted in many patients, while the flow of urine from the kidney normalized in all patients.

Conclusions. LDC compared to PCA was more effective in complete cyst removal and caused more significant decrease of cyst size. The LOS was longer after LDC, both LDC and PCA were effective in regaining urinary flow from the kidney. Back pain and hypertension should be considered relative indications for surgical treatment of kidney cysts.

About the authors

Igor A. Korneyev

I.P. Pavlov First Saint Petersburg State Medical University

Author for correspondence.
Email: iakorneyev@yandex.ru

doctor of medical science, professor, Department of Urology

Russian Federation, Saint Petersburg

Artem O. Kiselev

I.P. Pavlov First Saint Petersburg State Medical University

Email: iakorneyev@yandex.ru

student, Department of Urology

Russian Federation, Saint Petersburg

Evgenij Ju. Ishutin

I.P. Pavlov First Saint Petersburg State Medical University

Email: iakorneyev@yandex.ru

urologist, urologic clinic

Russian Federation, Saint Petersburg

Jurij A. Radomskij

I.P. Pavlov First Saint Petersburg State Medical University

Email: iakorneyev@yandex.ru

urologist, urologic clinic

Russian Federation, Saint Petersburg

Salman H. Al-Shukri

I.P. Pavlov First Saint Petersburg State Medical University

Email: alshukri@mail.ru

doctor of medical science, professor, head of the department. Department of Urology

Russian Federation, Saint Petersburg

References

  1. Ravine D, Gibson RN, Donlan J, Sheffield LJ. An ultrasound renal cyst prevalence survey: specificity data for inherited renal cystic diseases. Am J Kidney Dis. 1993;22(6):803-807. doi: 10.1016/s0272-6386(12)70338-4.
  2. Carrim ZI, Murchison JT. The prevalence of simple renal and hepatic cysts detected by spiral computed tomography. Clin Radiol. 2003;58(8):626-629. doi: 10.1016/s0009-9260(03)00165-x.
  3. Israel GM, Bosniak MA. An update of the Bosniak renal cyst classification system. Urology. 2005;66(3):484-488. doi: 10.1016/j.urology.2005.04.003.
  4. Chang CC, Kuo JY, Chan WL, et al. Prevalence and clinical characteristics of simple renal cyst. J Chin Med Assoc. 2007;70(11):
  5. -491. doi: 10.1016/S1726-4901(08)70046-7.
  6. Terada N, Arai Y, Kinukawa N, et al. The 10-year natural history of simple renal cysts. Urology. 2008;71:7-11. doi: 10.1016/j.urology.2007.07.075.
  7. Bryniarski P, Kaletka Z, Życzkowski M, et al. Ten-year treatment outcomes including blood cell count disturbances in patients with simple renal cysts. Eur Urology Suppl. 2013;12(4):e1166. doi: 10.1016/s1569-9056(13)61906-5.
  8. Zerem E, Imamovic G, Omerovic S. Simple renal cysts and arterial hypertension: does their evacuation decrease the blood pressure? J Hypertens. 2009;27(10):2074-2078. doi: 10.1097/HJH.0b013e32832f1458.
  9. Tatar E, Ozay E, Atakaya M, et al. Simple renal cysts in the solitary kidney: Are they innocent in adult patients? Nephrology (Carlton). 2017;22(5):361-365. doi: 10.1111/nep.12778.
  10. Зенков С.С., Захматов Ю.М., Трофимов К.С. Чрескожное пункционное лечение простых кист // Российский медицинский журнал. – 2003. – № 1. – С. 37-40. [Zenkov SS, Zakhmatov YuM, Trofimov KS. Transcutaneous paracentetic treatment of common renal cysts. Rossijskij Medicinskij Zhurnal. 2003;(1):37-40. (In Russ.)]
  11. Кадыров З.А., Самко А.А., Гурбанов Ш.Ш., и др. Эндовидеохирургические методы иссечения простых кист почек // Экспериментальная и клиническая урология. – 2010. – № 3. – С. 62–65. [Kadyrov ZA, Samko AA, Gurbanov SS, et al. Endoscopic methods of simple renal cysts excision. Experimental and Clinical Urology. 2010;(3):62-65. (In Russ.)]
  12. Аль-Шукри С.Х., Антонов А.В., Радомский Ю.А., Ишутин Е.Ю. К вопросу о выборе метода лечения кист почек // Нефрология. – 2005. – Т. 9. – № 1. – С. 75–78. [Al-Shukri SKh, Antonov AV, Radomsky YuA, Ishutin EYu. On a decision for method of treatment of kidney cysts. Nephrology. 2005;9(1):75-78. (In Russ.)]
  13. Park H, Kim CS. Natural 10-year history of simple renal cysts. Korean J Urol. 2015;56(5):351-356. doi: 10.4111/kju.2015.56.5.351.
  14. Li L, Chen CC, Zeng XQ. One-year results of single-session sclerotherapy with bleomycin in simple renal cysts. J Vasc Interv Radiol. 2012;23(12):1651-1656. doi: 10.1016/j.jvir.2012.08.030.
  15. Yonguc T, Sen V, Aydogdu O, et al. The comparison of percutaneous ethanol and polidocanol sclerotherapy in the management of simple renal cysts. Int Urol Nephrol. 2015;47(4):603-607. doi: 10.1007/s11255-015-0953-9.
  16. Yoder BM, Wolf JS Jr. Long-term outcome of laparoscopic decortication of peripheral and peripelvic renal and adrenal cysts. J Urol. 2004;171(2Pt1):583-587. doi: 10.1097/01.ju.0000103642.29044.71.
  17. Atug F, Burgess SV, Ruiz-Deya G, et al. Long-term durability of laparoscopic decortication of symptomatic renal cysts. Urology. 2006;68(2):272-275. doi: 10.1016/j.urology.2006.03.009.
  18. Kiryluk K, Gupta M. A large obstructive parapelvic cyst: challenging diagnosis and management. Kidney Int. 2007;71(9):955. doi: 10.1038/sj.ki.5002124.

Copyright (c) 2017 Korneyev I.A., Kiselev A.O., Ishutin E.J., Radomskij J.A., Al-Shukri S.H.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies