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Tseng WH, Hsieh CC, Huang SK, Liu CL, Lee KH, Hsieh KL, Chen ZH, Chiu AW, Li CF, Shiue YL. Advantages of retrograde intrarenal incision versus laparoscopic surgery in management of pararenal cysts: a single-center experience. Int Urol Nephrol 2024; 56:1307-1313. [PMID: 38044410 DOI: 10.1007/s11255-023-03881-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/03/2023] [Indexed: 12/05/2023]
Abstract
PURPOSE Renal cysts are typically a benign condition, and parapelvic cysts are a type of renal cyst that occur adjacent to the renal pelvis or renal sinus. Parapelvic cysts can increase the risk for injury to adjacent organs or urine leakage during laparoscopic surgery. Flexible ureteroscopes with laser assistance were used to make internal incisions in cysts. Perioperative outcomes of this method were compared with those of laparoscopic surgery. METHODS Eight-three patients, who underwent surgical treatment for renal cysts at the authors' medical center between January 2019 and June 2022, were evaluated. Two patients were excluded because they originally opted for RIRS but subsequently converted to laparoscopic surgery. Patients were divided into 2 groups based on surgery type: laparoscopic; and RIRS for internal incision. Outcomes in both groups were analyzed. RESULTS Of the 81 patients analyzed, 60 [74% (group 1)] underwent laparoscopic surgery and 21 [26% (group 2)] underwent RIRS for internal incision. The median operative durations for groups 1 and 2 were 87 and 56 min, respectively (p < 0.001). Relative to RIRS, laparoscopic surgery resulted in greater postoperative painkiller use (laparoscopic surgery versus [vs.] RIRS, 43% vs. 19%; p = 0.047). The median length of hospital stay was 2 and 1 days, respectively (p < 0.001). CONCLUSIONS RIRS demonstrated several advantages over laparoscopic surgery for the internal incision of parapelvic cysts, including shorter operative duration, shorter hospital stay, and less postoperative pain control. These findings may guide the selection of appropriate surgical approaches for patients with renal cysts.
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Affiliation(s)
- Wen-Hsin Tseng
- Institute of Biomedical Science, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
| | - Chia-Chih Hsieh
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC.
| | - Steven K Huang
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
| | - Chien-Liang Liu
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
- Division of Uro-Oncology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
| | - Kau-Han Lee
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
| | - Kun-Lin Hsieh
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
| | - Zhi-Hao Chen
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
| | - Allen W Chiu
- Department of Urology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chien-Feng Li
- Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Yow-Ling Shiue
- Institute of Biomedical Science, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan.
- Institute of Precision Medicine, College of Medicine, National Sun Yat-Sen University, No. 70, Lienhai Rd., Kaohsiung, 80424, Taiwan, ROC.
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2
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Santiana L, Samsudin AM. A rare case of parapelvic cyst: A case report. Radiol Case Rep 2024; 19:260-263. [PMID: 38028303 PMCID: PMC10630767 DOI: 10.1016/j.radcr.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 09/30/2023] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Parapelvic cyst (PPC) is a rare cyst that arises from the renal parenchyma and usually does not cause symptoms. However, PPC may cause compression of the pelvicalyceal system resulting in obstructive symptoms. Ultrasonography may not be sufficient to diagnose PPC since they are often misdiagnosed with hydronephrosis, thus computed tomography of the renal is required. In this case, we present, a 27 years old male with a 3 years history of partial urinary retention presented with intermittent loin pain. Hydronephrosis was found on ultrasonography but failed to identify the source of obstruction. A CT scan was conducted and a PPC was confirmed. Nephrostomy was scheduled for ureteral dilation and the patient responded well 4 months after surgery. In this case, we highlight the role of radiology in identifying and differentiating the PPC.
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Affiliation(s)
- Leni Santiana
- Department of Radiology, Faculty of Medicine, University of Padjadjaran, Dr. Hasan Sadikin General Hospital, Jl. Pasteur No.38, Pasteur, Sukajadi, Bandung City, West Java 40161 Indonesia
| | - Adi Maulana Samsudin
- Department of Radiology, Faculty of Medicine, University of Padjadjaran, Dr. Hasan Sadikin General Hospital, Jl. Pasteur No.38, Pasteur, Sukajadi, Bandung City, West Java 40161 Indonesia
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3
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Meng X, Mi Q. Transurethral flexible ureteroscopic incision and drainage with holmium laser in the treatment of parapelvic renal cysts: A retrospective study. Int Braz J Urol 2022; 48:842-849. [PMID: 35838511 PMCID: PMC9388182 DOI: 10.1590/s1677-5538.ibju.2022.0142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background: We aimed to investigate the clinical efficacy and safety of transurethral flexible ureteroscopic incision and drainage with holmium laser in the treatment of parapelvic renal cysts. Materials and Methods: Between October 2017 and April 2021, the clinical data of 65 patients with parapelvic renal cysts were evaluated retrospectively. Thirty-one patients with parapelvic cysts (Group 1) underwent a transurethral flexible ureteroscopic incision and drainage with a holmium laser, whereas the other 34 patients (Group 2) underwent retroperitoneal laparoscopic unroofing. The patients' clinical features were documented. The surgery time, intraoperative blood loss, hospitalization time, complications and cyst size were recorded and statistically assessed one year following the procedure. Results: All of the patients were successfully treated with flexible ureteroscopic incision and drainage or retroperitoneal laparoscopic unroofing. In terms of clinical parameters, such as age, gender, BMI, location, cyst size, and Bosniak classification of renal cysts, no statistically significant difference was detected between Groups 1 and 2. Compared to the control group (Group 2), Group 1 demonstrated a shorter surgery duration, less intraoperative blood loss, and a shorter hospital stay (p < 0.001). However, no significant differences in complications and cyst size were observed between the two groups one year after the surgery (p > 0.05). Conclusions: Transurethral flexible ureteroscopic incision and drainage with holmium laser in the treatment of parapelvic renal cysts has obvious advantages over traditional surgery, and is worthy of advancement and application, but its long-term effect needs further follow-up studies.
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Affiliation(s)
- Xiangjun Meng
- Department of Urology, Dongguan People's Hospital, Dongguan, Guangdong, P.R. China
| | - Qiwu Mi
- Department of Urology, Dongguan People's Hospital, Dongguan, Guangdong, P.R. China
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Marret JB, Blanc T, Balaton A, La Vignera S, Zanghì G, Lottmann HB, Bagnara V. Symptomatic Parapelvic Cysts in Children: Anatomical and Histological Features, Diagnostic Pitfalls and Urological Management. J Clin Med 2022; 11:jcm11072035. [PMID: 35407642 PMCID: PMC9000015 DOI: 10.3390/jcm11072035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/27/2022] [Accepted: 03/31/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Symptomatic parapelvic cysts (PPC) are rare entities. Our objective is to highlight specific features of PPC to avoid a misdiagnosis of UPJ obstruction. Methods: We retrospectively reviewed the records of children managed between 2012–2017. Results: All four patients (18 months–8 years) presented with acute renal colic with a large intra-sinusal liquid mass (42–85 mm) on ultrasound, evoking a diagnosis of UPJ obstruction. On preoperative renal scintigraphy (n = 3) there was no dilatation of the renal pelvis and ipsilateral differential function was impaired in 2. Diagnosis of PPC was suspected preoperatively in three children (CT scan (n = 1); MRI (n = 2)) and made peri-operatively (n = 1). Preoperative retrograde pyelography (n = 3) and a further intraoperative retrograde pyelography with methylene blue (n = 1) did not identify communication with the cyst. No renal pelvis was identified in two patients. De-roofing of the cyst was curative in all cases at 5 years mean follow-up (no leakage, cyst recurrence or loss of function) and all 4 patients became asymptomatic after surgery. Histology demonstrated a single flat epithelial cell layer. Renal function normalized in one patient but remained impaired in the other. Conclusion: In case of symptoms of UPJ obstruction with a medial renal liquid mass on ultrasound, PPC should be considered when no dilatated pelvis on renal scan is identified. In such cases, a complementary imaging work-up is mandatory prior to surgery.
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Affiliation(s)
- Jean-Baptiste Marret
- Department of Paediatric Surgery and Urology, Hôpital Necker Enfants Malades, APHP, Université de Paris, 149 Rue de Sèvres, 75015 Paris, France; (J.-B.M.); (T.B.); (H.B.L.)
| | - Thomas Blanc
- Department of Paediatric Surgery and Urology, Hôpital Necker Enfants Malades, APHP, Université de Paris, 149 Rue de Sèvres, 75015 Paris, France; (J.-B.M.); (T.B.); (H.B.L.)
- Mechanisms and Therapeutic Strategies of Chronic Kidney Disease, INSERM U1151-CNRS UMR 8253, Institut Necker Enfants Malades, Département “Croissance et Signalisation”, Hôpital Necker Enfants Malades, Université de Paris, 149 Rue de Sèvres, 75015 Paris, France
| | - Andre Balaton
- Department of Pathology, Praxea Diagnostics, 1 Rue Galvani, 91300 Massy, France;
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
- Correspondence:
| | - Guido Zanghì
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy;
| | - Henri Bernard Lottmann
- Department of Paediatric Surgery and Urology, Hôpital Necker Enfants Malades, APHP, Université de Paris, 149 Rue de Sèvres, 75015 Paris, France; (J.-B.M.); (T.B.); (H.B.L.)
| | - Vincenzo Bagnara
- Department of Paediatric Surgery, Policlinico “G.B. Morgagni”, Via Del Bosco 105, 95125 Catania, Italy;
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Lovin JM, Kirsch AJ, De S. Parapelvic cyst: A rare cause of ureteropelvic junction obstruction in a pediatric patient managed with robotic cyst decortication. J Pediatr Urol 2021; 17:864-865. [PMID: 34479807 DOI: 10.1016/j.jpurol.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/26/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION We report a case of a right parapelvic renal cyst causing intermittent ureteropelvic junction obstruction (UPJO). DIAGNOSTIC EVALUATION A 13-year-old male was referred for right flank pain. Stone protocol CT revealed renal pelvis dilation with punctate stones. Due to concern for intermittently obstructive calculi, he underwent ureteroscopy, which was unremarkable. A diuretic renogram showed symmetric uptake with partial emptying on the right with pain after diuretic administration. In office, we potentiated a Dietl's crisis with ultrasound obtained before and after fluid intake. Comparison of ultrasounds revealed a parapelvic cyst causing calyceal dilation. He was counseled for robotic cyst decortication and possible pyeloplasty. SURGICAL CONSIDERATIONS A robotic cyst decortication was performed. Once decorticated, the cyst base was fulgurated and pararenal fat was interposed into the cyst base. Console time was 70 min with minimal blood loss. The patient was discharged post-operative day 1. Follow-up renal ultrasound at 4 months demonstrated resolution of hydronephrosis and parapelvic cyst. CONCLUSION Parapelvic renal cysts causing intermittent UPJO is a rare entity that may be missed on a diuretic renogram. Clinical suspicion and appropriate imaging with ultrasound or magnetic resonance imaging are useful. Robotic cyst decortication is a technically feasible approach to treat this condition.
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Affiliation(s)
- Jennifer M Lovin
- Section of Pediatric Urology, Children's Healthcare of Atlanta and Emory University School of Medicine, 5730 Glenridge Drive, NE, Atlanta, GA, USA.
| | - Andrew J Kirsch
- Section of Pediatric Urology, Children's Healthcare of Atlanta and Emory University School of Medicine, 5730 Glenridge Drive, NE, Atlanta, GA, USA.
| | - Shuvro De
- Section of Pediatric Urology, Children's Healthcare of Atlanta and Emory University School of Medicine, 5730 Glenridge Drive, NE, Atlanta, GA, USA.
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Chen Y, Wang R, Shen X, Tang J, Shen J, Fang Z, Shi Z, Jin X. Ultrasonography-assisted flexible ureteroscope for the treatment of parapelvic renal cysts: A comparison between the 1470-nm diode laser and the holmium laser. Exp Ther Med 2020; 21:172. [PMID: 33456539 PMCID: PMC7792476 DOI: 10.3892/etm.2020.9603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 10/30/2020] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to compare the efficacy and safety of a flexible ureteroscopic holmium laser incision with flexible ureteroscopic 1470-nm diode laser incision for the treatment of parapelvic renal cysts. The current study collected and analysing the clinical data of 90 independent renal cysts cases retrospectively, including 43 renal cysts cases that received holmium laser surgery (holmium laser group) and 47 renal cysts cases that received 1470-nm diode laser surgery (1470-nm diode laser group). Each group was divided into a thin-walled cyst subgroup and thick-walled cyst subgroup according to cyst wall thickness. Intracapsular hematoma was significantly lower in the 1470-nm diode laser group compared with the holmium laser group (0/47 vs. 4/43; P=0.048). The incision diameter in the 1470-nm diode laser group was significantly larger than the holmium laser group in the thick-walled parapelvic renal cysts subgroup [1.70(1.50,1.90) vs. 1.30(1.25,1.70) cm; P=0.007]. The renal cystic diameter of the two groups was markedly reduced one and six months after surgery. The difference was non-significant in the diameter of the renal cyst in the thin-walled cysts subgroups between the two laser groups 6 months after surgery (1.01±0.38 vs. 1.03±0.53 cm; P=0.454). However, the diameter of the renal cyst in the thick-walled cysts subgroup treated with the 1470-nm diode laser was significantly lower compared with the thick-walled cysts subgroup treated with the holmium laser 6 months after surgery (1.21±0.57 vs. 1.88±0.94 cm; P=0.002). The results demonstrated that the use of a 1470-nm diode laser or holmium laser surgery under a flexible ureteroscope is a safe and effective treatment for parapelvic renal cysts. For thick-walled parapelvic renal cysts, the 1470-nm diode laser appears to exhibit a lower postoperative recurrence rate and better long-term postoperative effects due to its improved haemostatic effect and larger intraoperative incision diameter.
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Affiliation(s)
- Yu Chen
- Department of Urology, The First Affiliated Hospital of Zhejiang University School of Medicine, Huzhou, Zhejiang 313100, P.R. China.,Department of Urology, The First Affiliated Hospital of Huzhou Teacher's University, The First People's Hospital of Huzhou City, Huzhou, Zhejiang 313100, P.R. China
| | - Rongjiang Wang
- Department of Urology, The First Affiliated Hospital of Huzhou Teacher's University, The First People's Hospital of Huzhou City, Huzhou, Zhejiang 313100, P.R. China
| | - Xufeng Shen
- Department of Urology, The First Affiliated Hospital of Huzhou Teacher's University, The First People's Hospital of Huzhou City, Huzhou, Zhejiang 313100, P.R. China
| | - Jianer Tang
- Department of Urology, The First Affiliated Hospital of Huzhou Teacher's University, The First People's Hospital of Huzhou City, Huzhou, Zhejiang 313100, P.R. China
| | - Junwen Shen
- Department of Urology, The First Affiliated Hospital of Huzhou Teacher's University, The First People's Hospital of Huzhou City, Huzhou, Zhejiang 313100, P.R. China
| | - Zhihai Fang
- Department of Urology, The First Affiliated Hospital of Huzhou Teacher's University, The First People's Hospital of Huzhou City, Huzhou, Zhejiang 313100, P.R. China
| | - Zhanqin Shi
- Department of Urology, The First Affiliated Hospital of Huzhou Teacher's University, The First People's Hospital of Huzhou City, Huzhou, Zhejiang 313100, P.R. China
| | - Xiaodong Jin
- Department of Urology, The First Affiliated Hospital of Zhejiang University School of Medicine, Huzhou, Zhejiang 313100, P.R. China
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Chen H, Li Y, Zeng F, He C, Cui Y, Chen J, Zeng H, Lu S, Wang W, Chen Z. Percutaneous nephrostomic decortication: a microinvasive surgery for posterior renal cyst. Transl Androl Urol 2020; 9:2764-2770. [PMID: 33457248 PMCID: PMC7807317 DOI: 10.21037/tau-20-875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
To assess the safety, feasibility, and efficacy of a modified process we developed in order to perform decortication surgeries for simple renal cysts through a percutaneous approach, 18 patients with simple renal cysts larger than 5 cm were treated with our new technique, from November 2016 to January 2019. All of the cysts were evaluated with ultrasonography and contrast-enhanced computed tomography. The Surgical procedure: as the standard mini-Percutaneous Nephrostomy procedure, a puncture was made directly into the cyst through the cyst roof under ultrasound guidance. After the inner cyst wall examination, the sheath was then retracted to just outside the cyst roof. The sheath together with the scope was used to detach the roof from the perirenal fat, after which the cyst roof was resected using a laser. A drain tube was left in the retroperitoneal space for 1-2 days. Subsequently, all patients were discharged 1 to 2 days post-surgery. Skin incision was less than 1 cm. No major complication was observed. The follow-up time ranges from 14 to 37 months. One case had an incompletely resected cyst with the cyst volume being decreased by more than 60%. This patient didn't receive any additional treatments during his follow-up. For all the other patients, the cysts had completely disappeared and no relapse had occurred. In conclusion, in the selected patients with a simple posterior renal cyst, our new technique is a safe and an effective option. It is also considered the least invasive decortication surgery for posterior renal cyst.
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Affiliation(s)
- Hequn Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Feng Zeng
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Cheng He
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Yu Cui
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Huimin Zeng
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Siqi Lu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Weiguo Wang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhiyong Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
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8
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Huang B, Lu G, Tu W, Zhao Y, Wang Y, Zhang L, Shao Y, Wang D. Factors Influencing Surgical Outcome in Retrograde Management of Parapelvic Renal Cysts. J Endourol 2020; 35:466-472. [PMID: 33050738 DOI: 10.1089/end.2020.0508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the outcomes of retrograde flexible ureteroscopy in managing parapelvic renal cysts and speculate the factors affecting therapeutic efficacy. Methods: Thirty-eight patients with parapelvic renal cysts were recruited and underwent retrograde flexible ureteroscopy using holmium laser. Parapelvic cysts were divided into peripheral type and central type based on the position of cyst convex to the perirenal tissue. Feasibility and safety were retrospectively evaluated, and cases were analyzed to detect their distinctive characteristics. Independent-sample t-test and chi-square test were undertaken for continuous variables and categorical variables, respectively. Results: Radiologic evidence of success was achieved in 31 (81.58%) cases after a mean follow-up of 14.4 months (range 6-26 months). No significant perioperative complications were identified. There were seven cases with features of peripherally located parapelvic cyst. Four cysts shown as irregular protrusion were unable reduce to less half of previous size. Reductions were recorded in the other three patients with spherically peripheral protrusion. There was significant difference between these two types (p = 0.029). Among the 31 patients with centrally located parapelvic cyst, 28 of these have simple cysts that achieved radiologic success and 3 of the 31 patients were identified as failed cases indicated by renal pelvis enveloped by cyst on radiologic investigation. The success rate of simple cysts was significantly higher than that of the later type (p < 0.001). Conclusion: The location and shape of parapelvic cyst may play a critical role in the radiologic outcome of internal incision and patients with simple central or spherical peripheral cyst may benefit more from retrograde flexible ureteroscopy combined with laser incision.
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Affiliation(s)
- Baoxing Huang
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Guoliang Lu
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Weichao Tu
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yang Zhao
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yuanchun Wang
- Monash Health, Faculty of Medicine, Monash University, Melbourne, Australia
| | - Lin Zhang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia.,Victorian Comprehensive Cancer Centre, The University of Melbourne Centre for Cancer Research, Parkville, Australia
| | - Yuan Shao
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Dawei Wang
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Urology, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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9
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Khoder WY, Grabbert M, Sigle A, Astheimer S, Vallo S, Gratzke C. Retrospective Evaluation of the Clinical Values of Minimally Invasive Marsupialization of Symptomatic Giant Renal Cysts. J Laparoendosc Adv Surg Tech A 2020; 31:279-283. [PMID: 33074753 DOI: 10.1089/lap.2020.0415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: To evaluate the indication and benefit of minimally invasive laparoscopic marsupialization (MIS) of symptomatic giant renal cysts. Materials and Methods: Sixty-four consecutive patients who underwent MIS for large renal cysts (Bosniak I; 4 × 5-16 × 12 cm) by one surgeon were included in the study. Presenting symptoms were renal pain (100%), associated with hypertension (28%), renal dysfunction (4.7%), hematuria (4.7%), ureteropelvic junction obstruction (UPJO) (7.8%), ipsilateral urolithiasis (4.7%), polycystic kidney (6.3%), adrenal cyst (1.6%), and retroperitoneal cysts (1.6%). Seven patients with peripelvic cysts and previous retroperitoneal operations were treated by a laparoscopic approach; all other patients underwent retroperitoneoscopic marsupialization. Single-port retroperitoneoscopy was performed in 4 patients. Follow-up included clinical examination, abdominal ultrasound, and computed tomography scan. Postoperative radiologic success was defined as a minimum of 50% in size reduction and no recurrence. Results: Mean patients' age was 46 (21-65) years. All procedures were successfully completed without conversion or revision. Mean operative time was 55 (40-85) minutes with a mean hospital stay of 3 days. All patients underwent uneventful postoperative recovery. Observed minor complications (transitory fever/pain) were found in 4 patients during the first postoperative month. Median follow-up was 12 months (10 months-2 years). About 98.5% of patients reported of no relevant postoperative pain. A relief from UPJO and hematuria was achieved in 100% of patients. Ten patients with known hypertensive disease (55.6%) had a significant reduction of mean blood pressure resulting in a reduction of antihypertensive medication. Ureterorenoscopic stone extractions were performed successfully afterward. No cyst recurrences were detected during the follow-up period. Conclusion: Treatment indications for symptomatic renal cysts could include not only symptoms but also associated diseases like UPJO and hypertension. Retroperitoneoscopic MIS may be curative for these cyst-associated pathologies. The feasibility, safety and efficacy of these techniques could be demonstrated.
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Affiliation(s)
- Wael Y Khoder
- Department of Urology, Freiburg University Hospital, Freiburg, Germany
| | - Markus Grabbert
- Department of Urology, Freiburg University Hospital, Freiburg, Germany
| | - August Sigle
- Department of Urology, Freiburg University Hospital, Freiburg, Germany
| | - Sophie Astheimer
- Department of Urology, Freiburg University Hospital, Freiburg, Germany
| | - Stefan Vallo
- Klinik für Urologie, Hochtaunus-Kliniken, Bad Homburg vor der Höhe, Germany
| | - Christian Gratzke
- Department of Urology, Freiburg University Hospital, Freiburg, Germany
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10
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Zewu Z, Hequn C, Yu C, Yang L, Zhongqing Y, Zhiyong C, Feng Z. Long-term outcome after flexible ureteroscopy with holmium laser for simultaneous treatment of a single renal cyst and ipsilateral renal stones. J Int Med Res 2019; 47:3601-3612. [PMID: 31218939 PMCID: PMC6726797 DOI: 10.1177/0300060519855573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/16/2019] [Indexed: 12/12/2022] Open
Abstract
Objective To assess the long-term outcome of simultaneous treatment of a single renal cyst and ipsilateral stones with transurethral flexible ureteroscopy (FURS) lithotripsy and internal cyst drainage. Methods Patients who underwent simultaneous treatment with FURS lithotripsy and internal cyst drainage in our institution between July 2014 and September 2017 were enrolled. The cyst wall was identified endoscopically and a 1–3-cm window was created in the wall using a holmium laser. The proximal end of a double-J stent was placed in the cystic cavity to facilitate internal drainage. Results Thirteen patients underwent simultaneous treatment. No intraoperative complications with Clavien grading score >2 were noted in any patients. Mean stone burden and cyst diameter were 1.6 (range: 0.9–2.5) cm and 5.8 (range: 3.0–7.1) cm, respectively. Stone-free rates after single and complementary procedures were 84.6% and 92.3%, respectively. During the mean 33.1-month follow-up period (range: 17–54 months), seven patients (53.8%) achieved full resolution of renal cysts, five patients (38.5%) maintained >50% size reduction, and one patient (7.6%) experienced recurrence at 18 months postoperatively. Conclusions FURS with a holmium laser may constitute a safe and effective alternative procedure for simultaneous treatment of a single renal cyst and ipsilateral stones.
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Affiliation(s)
- Zhu Zewu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Chen Hequn
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Cui Yu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Li Yang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Zhongqing
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Chen Zhiyong
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Zeng Feng
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
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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; 125:243-247. [PMID: 30452965 DOI: 10.1016/j.urology.2018.11.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 10/29/2018] [Accepted: 11/05/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To describe a modified technique for easily locating cystic wall during flexible ureteroscopic surgery for treatment of parapelvic renal cysts. METHODS Nineteen patients with symptomatic/asymptomatic parapelvic renal cyst were treated with modified or conventional flexible ureteroscopic surgery between February 2015 and March 2017, and the differences of the 2 techniques were compared. The detailed surgical procedures and results, postoperative complications, and patients' follow-ups were evaluated. RESULTS All the patients received endoscopic management by flexible ureteroscope successfully, without requiring another complicated surgery. The cysts were seen clearly in 9 patients with modified method. Two of ten patients who underwent conventional ureteroscopic surgery changed to the modified surgery intra-operatively since it was difficult to identify the cyst. The total time of search and incision of cysts was 24.2 ± 6.2 minutes and 17.7 ± 2.5 minutes for conventional and modified technique respectively (P = .01), of which 11.4 ± 4.8 minutes and 5.1 ± 1.1 minutes to search the cysts, respectively (P = .002), and the mean time of the procedure of puncture was 8 ± 2.3 minutes. Duration of pure incising the cystic wall was 12.8 ± 3.3 minutes and 12.6 ± 2.5 minutes for patients who underwent conventional and modified technique, respectively (P = .859). All patients acquired relief from the presentation of flank discomfort after surgery. All of the patients were followed-up over 12 months and no serious complications and recurrence was observed. CONCLUSION The modified technique can decrease time of searching the renal cyst and decrease the total time in flexible ureteroscopic treatment of parapelvic cysts. The limitations of our study were also observed and further studies are needed.
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Affiliation(s)
- Zhixian Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyong Zeng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chong Chen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruibao Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Mancini V, Cormio L, d'Altilia N, Benedetto G, Ferrarese P, Balzarro M, Defidio L, Carrieri G. Retrograde Intrarenal Surgery for Symptomatic Renal Sinus Cysts: Long-Term Results and Literature Review. Urol Int 2018; 101:150-155. [PMID: 29719301 DOI: 10.1159/000488685] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 03/21/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To report the long-term multicenter experience with retrograde intrarenal holmium-laser incision (RIR-HoLI) in the management of symptomatic renal sinus cysts (RSCs). In the literature, RIR-HoLI has been shown to be a safe and effective treatment, but there are only a few reports regarding long-term results and reproducibility of this procedure. MATERIAL AND METHODS From June 2010 to June 2015, 14 patients with symptomatic RSCs underwent RIR-HoLI. The mean age was 52.1 ± 11.28 years (range 28-77) and the mean cyst size was 53.2 ± 14.23 mm (range 35-90). In all cases, contrast-enhanced computer tomography (CT) showed compression of the renal pelvis by the cyst (no malignancy). Surgical outcome was assessed in terms of symptoms improvement (measured by Visual Analogue Scale [VAS] for pain) and renal ultrasound findings at 3-6-12 months postoperatively and then yearly. CT scan was carried out at 12 months follow-up. RESULTS RIR-HoLI was successful in all patients. The mean operative time was 47.8 ± 13.54 min (range 30-80) and mean hospital stay was 3.5 days (range 2-5). There were 2 Clavien grade II complications (flank pain and urgency delaying discharge). After surgery, all patients -became asymptomatic (VAS score change, p = 0.0001). One patient had persistence of a small cyst (10 mm). Mean follow-up is 44 ± 17.24 months (range 24-84); all patients remained asymptomatic, with no signs of recurrence. CONCLUSIONS RIR-HoLI proved to be a safe and effective treatment for symptomatic RSCs. In our experience, it provided excellent long-term results and was reproducible at 4 different -institutions.
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Affiliation(s)
- Vito Mancini
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Luigi Cormio
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Nicola d'Altilia
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Giuseppe Benedetto
- Department of Urology, San Bortolo Hospital, ULSS 8 Berica, Vicenza, Italy
| | - Paolo Ferrarese
- Department of Urology, San Bortolo Hospital, ULSS 8 Berica, Vicenza, Italy
| | | | | | - Giuseppe Carrieri
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
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Coggins WS, Hudgins HK, Kosarek CD, Roberts RL. A peripelvic renal cyst resulting in clinically symptomatic ureteropelvic junction obstruction. Urol Case Rep 2018; 16:69-71. [PMID: 29321973 PMCID: PMC5760737 DOI: 10.1016/j.eucr.2017.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/06/2017] [Accepted: 11/12/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- William S Coggins
- School of Medicine, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA
| | - Hogan K Hudgins
- School of Medicine, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA
| | - Christopher D Kosarek
- Division of Urology, Department of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA
| | - Robyn L Roberts
- Division of Urology, Department of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA
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Ji C, Yang Y, Zhao X, Zhang G, Zhang S, Liu G, Li X, Guo H. Laparoscopic Partial Nephrectomy for Peripelvic Cystic Renal Cell Carcinoma: A Single-Center Experience. Urol Int 2016; 97:153-7. [DOI: 10.1159/000447598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/13/2016] [Indexed: 11/19/2022]
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Bas O, Nalbant I, Can Sener N, Firat H, Yeşil S, Zengin K, Yalcınkaya F, Imamoglu A. Management of renal cysts. JSLS 2016; 19:e2014.00097. [PMID: 25848184 PMCID: PMC4376217 DOI: 10.4293/jsls.2014.00097] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives: Renal cysts have a high prevalence in the general population, and their estimated incidence increases with age. Renal cyst aspiration (usually with sclerotherapy) or open/laparoscopic decortication is a generally effective and safe method in the treatment of symptomatic simple renal cysts. The success rates of laparoscopic decortication and percutaneous aspiration-sclerotherapy were compared to assist in the decision making for the procedure. Methods: A total of 184 patients with symptomatic simple renal cysts were treated with either laparoscopic decortication in 149 cases or percutaneous aspiration-sclerotherapy in 35 cases. The follow-up period was approximately 35 months, and the symptomatic and radiologic success rates of the 2 techniques were compared retrospectively. Results: Laparoscopic decortication was found to have high success rates, a low recurrence rate, and minimal morbidity. Percutaneous aspiration-sclerotherapy is an outpatient procedure with a minimally higher recurrence rate. Conclusion: When a symptomatic cyst is encountered and treatment of the cyst is indicated, laparoscopic decortication is a more efficient method that offers better results than percutaneous aspiration-sclerotherapy.
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Affiliation(s)
- Okan Bas
- Department of Urology, Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ministry of Health, Ankara, Turkey
| | - Ismail Nalbant
- Department of Urology, Yenimahalle State Hospital, Ministry of Health, Ankara, Turkey
| | - Nevzat Can Sener
- Department of Urology, Numune Education and Research Hospital, Ministry of Health, Adana, Turkey
| | - Hacer Firat
- Department of Radiology, Diskapi Yildirim Beyazid Education and Research Hospital, Ministry of Health, Ankara, Turkey
| | - Süleyman Yeşil
- Department of Urology, Gazi University School of Medicine, Ankara, Turkey
| | - Kürşad Zengin
- Department of Urology, Bozok University School of Medicine, Yozgat, Turkey
| | - Fatih Yalcınkaya
- Department of Urology, Diskapi Yildirim Beyazid Education and Research Hospital, Ministry of Health, Ankara, Turkey
| | - Abdurrahim Imamoglu
- Department of Urology, Diskapi Yildirim Beyazid Education and Research Hospital, Ministry of Health, Ankara, Turkey
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16
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Treatment of Parapelvic Cyst by Internal Drainage Technology Using Ureteroscope and Holmium Laser. W INDIAN MED J 2015; 64. [PMID: 26426175 DOI: 10.7727/wimjopen.2014.220] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 09/17/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of parapelvic cyst treatment is to have complete drainage of cyst fluid and prevent its further compression of the kidney and collective system. This study explores the efficacy and safety of surgical approaches with holmium laser ureteroscopic internal drainage in the treatment of parapelvic cyst. METHODS The compression effect of parapelvic cyst on the renal collective system was observed by rigid ureteroscope using retrograde ureteroscopic technology. With direct vision, the cyst wall on the obvious parapelvic compression site was cut. The diameter of the cyst wall cut was about 1 cm. The internal drainage was obtained by double-J tubes. When the cyst was in the inferior pole of kidney or where the rigid ureteroscope could not reach, a flexible ureteroscope was used. RESULTS In 28 cases of operation, 27 cases were successful. The cyst treatment time was eight to 40 minutes (average 26 minutes). During the operation, no massive haemorrhage, damage of nearby organ and ureter, or other complications happened. Time of follow-up was 10-72 months (average 39 months). The results of follow-up showed that in 22 cases, the cyst disappeared; the diameter of the cyst in four cases was reduced by more than half, and one case recurred. CONCLUSION The treatment of parapelvic cyst by internal drainage operation using holmium laser and ureteroscopy was effective. The operation was safe with few complications.
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17
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Mao X, Xu G, Wu H, Xiao J. Ureteroscopic management of asymptomatic and symptomatic simple parapelvic renal cysts. BMC Urol 2015; 15:48. [PMID: 26048408 PMCID: PMC4456808 DOI: 10.1186/s12894-015-0042-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 05/21/2015] [Indexed: 12/24/2022] Open
Abstract
Background To investigate feasibility and safety of treating simple parapelvic renal cysts using flexible ureteroscopy with the Holmium laser. Methods Between February 2010 and July 2013, a total of 21 patients, aging from 29 to 71 (49.00 ± 13.23), were diagnosed with parapelvic renal cysts by ultrasonography in combination with contrast-enhanced computer tomography (CT) and intravenous urography (IVU) in the Department of Urology Surgery, People’s Hospital of the Zhejiang province. Fifteen patients were asymptomatic and 6 patients were symptomatic with flank pain. All patients underwent drainage of the cysts using flexible ureteroscopy with Holmium laser. Patients were followed up 1, 3 and 12 months after the operation. Results The intervention was successful in 20 patients and failed in 1 patient who, subsequently successfully underwent a laparoscopic cyst removal. There were no intra-operative and post-operative complications reported. The mean operation time was 27 min (range: 15 to 45 min). The mean hospital stay was 2.6 days (range: 1 to 5 days). Twenty patients were followed up until 15 months after surgery. After such ureteroscopic management, there were no renal cysts detected in 7 patients (35 %) and a reduction in size of the renal cysts was found in 13 patients (65 %). Flank pain subsided in all 6 (100 %) previously symptomatic patients. Conclusions Flexible ureteroscopy with the Holmium laser may be a feasible and effective treatment option in selected patients with simple parapelvic renal cysts. Further prospective randomized studies that compare the procedure to laparoscopic treatments are needed.
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Affiliation(s)
- XiaWa Mao
- Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China.
| | - Gang Xu
- Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China.
| | - HuiFeng Wu
- Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China.
| | - JiaQuan Xiao
- Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China.
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Topaktas R, Tepeler A. How should we treat renal calculi accompanying to simple renal cyst? Urology 2015; 85:484. [PMID: 25623723 DOI: 10.1016/j.urology.2014.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 10/02/2014] [Accepted: 10/04/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Ramazan Topaktas
- Diyarbakir Gazi Yasargil Egitim ve Arastirma Hastanesi, Diyarbakir, Turkey
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19
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Treatment of renal parapelvic cysts with a flexible ureteroscope. Int Urol Nephrol 2014; 46:1903-8. [DOI: 10.1007/s11255-014-0741-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 05/08/2014] [Indexed: 10/25/2022]
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20
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Affiliation(s)
- Dalsan You
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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21
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Shao ZQ, Guo FF, Yang WY, Wang GJ, Tan SF, Li HL, He XF, Wang JM, Liu HJ, Xia SJ. Percutaneous intrarenal marsupialization of symptomatic peripelvic renal cysts: A single-centre experience in China. Scand J Urol 2012; 47:118-21. [DOI: 10.3109/00365599.2012.704942] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Retroperitoneoscopic Decortication of Symptomatic Peripelvic Renal Cysts: Chinese Experience. Urology 2011; 78:803-7. [DOI: 10.1016/j.urology.2011.06.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Revised: 06/10/2011] [Accepted: 06/10/2011] [Indexed: 11/19/2022]
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Lee JY, Lee SW. Laparoendoscopic single-site renal cyst marsupialization using a homemade single-port device has a role as a feasible treatment option. Urol Int 2011; 87:309-13. [PMID: 21876318 DOI: 10.1159/000327509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 03/12/2011] [Indexed: 11/19/2022]
Abstract
AIM In patients with a renal cyst and concurrent symptoms, we examined the effectiveness and safety of laparoendoscopic single-site surgery (LESS) for renal cyst marsupialization using a homemade single-port device (HSPD) by a single surgeon (S.W.L.). PATIENTS AND METHODS The present study was conducted on a total of 31 patients with a renal cyst. A LESS renal cyst marsupialization was performed using a HSPD based on the Alexis® wound retractor and a powder-free surgical glove. In our study, the mean age was 55.29 ± 10.86 (range 31-73) years and the mean size of the renal cyst was 6.83 ± 1.09 cm. RESULTS All the surgical procedures were successfully performed. The mean operative time was 101.35 ± 16.04 min. Of the patients who underwent the procedure, none presented with major complications. In 7 patients who had pain preoperatively, there was a significant difference in the visual analogue pain scale score at 6.86 ± 0.69 preoperatively and 1.71 ± 0.49 at postoperative week 4 (p < 0.001). The number of patients who were satisfied with the postoperative outcome was 29 (93.5%). CONCLUSIONS In patients with a simple renal cyst, LESS renal cyst marsupialization using a HSPD might be considered as a feasible, safe surgical treatment option.
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Affiliation(s)
- Joo Yong Lee
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
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24
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Li EC, Hou JQ, Yang LB, Yuan HX, Hang LH, Alagirisamy KK, Li DP, Wang XP. Pure Natural Orifice Translumenal Endoscopic Surgery Management of Simple Renal Cysts: 2-Year Follow-Up Results. J Endourol 2011; 25:75-80. [PMID: 21247290 DOI: 10.1089/end.2009.0676] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- En-Chun Li
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jian-Quan Hou
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lin-Bin Yang
- Department of Urology, Jiaxing First Hospital, Jiaxing, Zhejiang, China
| | - He-Xing Yuan
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Li-Hua Hang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | | | - Da-Peng Li
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiao-Ping Wang
- Department of Urology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
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Basiri A, Hosseini SR, Tousi VN, Sichani MM. Ureteroscopic Management of Symptomatic, Simple Parapelvic Renal Cyst. J Endourol 2010; 24:537-40. [DOI: 10.1089/end.2009.0326] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Abbas Basiri
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University, Tehran, Iran
| | - Seyed Reza Hosseini
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University, Tehran, Iran
| | - Vahid Najjaran Tousi
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University, Tehran, Iran
| | - Mehrdad Mohammadi Sichani
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University, Tehran, Iran
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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. [DOI: 10.1089/end.2009.0042] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Salvatore Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovannalberto Pini
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Stefano De Stefani
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Filippo Annino
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giampaolo Bianchi
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
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Porpiglia F, Fiori C, Billia M, Renard J, Di Stasio A, Vaccino D, Bertolo R, Scarpa RM. Retroperitoneal decortication of simple renal cysts vs decortication with wadding using perirenal fat tissue: results of a prospective randomized trial. BJU Int 2009; 103:1532-6. [DOI: 10.1111/j.1464-410x.2008.08294.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Mingoli A, Brachini G, Binda B, Carocci V, Tiddi C, Modini C. Laparoscopic Transperitoneal Decortication of a Giant Peripelvic Renal Cyst. J Laparoendosc Adv Surg Tech A 2008; 18:845-7. [DOI: 10.1089/lap.2008.0047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Andrea Mingoli
- Emergency Department, Division of Trauma and Emergency Surgery, Sapienza University, Rome, Italy
| | - Gioia Brachini
- Emergency Department, Division of Trauma and Emergency Surgery, Sapienza University, Rome, Italy
| | - Barbara Binda
- Emergency Department, Division of Trauma and Emergency Surgery, Sapienza University, Rome, Italy
| | - Valentina Carocci
- Emergency Department, Division of Trauma and Emergency Surgery, Sapienza University, Rome, Italy
| | - Corinna Tiddi
- Emergency Department, Division of Trauma and Emergency Surgery, Sapienza University, Rome, Italy
| | - Claudio Modini
- Emergency Department, Division of Trauma and Emergency Surgery, Sapienza University, Rome, Italy
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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. [PMID: 18422580 DOI: 10.1111/j.1442-2042.2008.02031.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Shahin Abbaszadeh
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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30
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Choi SH, Seo IY, Rim JS. Comparison of the Surgical Outcome of Laparoscopic Cyst Marsupialization for Peripheral and Parapelvic Renal Cysts. Korean J Urol 2008. [DOI: 10.4111/kju.2008.49.6.497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Seung Hwa Choi
- Department of Urology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan, Korea
| | - Ill Young Seo
- Department of Urology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan, Korea
| | - Joung Sik Rim
- Department of Urology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan, Korea
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32
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O'Connor RC, Guralnick ML, Byrd GF, Murphy MJ, Sulman A. Case Report: Endoscopic Unroofing of Symptomatic Peripelvic Simple Renal Cyst. J Endourol 2007; 21:1497-9. [DOI: 10.1089/end.2006.0469] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R. Corey O'Connor
- Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Gregory F. Byrd
- Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Michael J. Murphy
- Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Aaron Sulman
- Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
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Shah JB, Whitman C, Lee M, Gupta M. Water under the Bridge: 5-Year Outcomes after Percutaneous Ablation of Obstructing Parapelvic Renal Cysts. J Endourol 2007; 21:1167-70. [DOI: 10.1089/end.2007.9914] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jay B. Shah
- Department of Urology, Columbia University Medical Center, New York, New York
| | - Catherine Whitman
- Department of Urology, Columbia University Medical Center, New York, New York
| | - Michael Lee
- Department of Urology, Columbia University Medical Center, New York, New York
| | - Mantu Gupta
- Department of Urology, Columbia University Medical Center, New York, New York
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Clayman R. Urolithiasis, Endourology and Laparoscopy. J Urol 2007. [DOI: 10.1016/j.juro.2006.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bibliography. Current world literature. Minimally invasive surgery in urology. Curr Opin Urol 2006; 16:112-7. [PMID: 16479214 DOI: 10.1097/01.mou.0000193398.85092.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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