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Yoon S, Kwak J, Im D, Yoon H. Review of outcomes of using lower ethanol concentration (83%) in percutaneous ultrasound-guided renal cyst sclerotherapy in dogs. J Vet Sci 2023; 24:e61. [PMID: 37638709 PMCID: PMC10556289 DOI: 10.4142/jvs.23045] [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: 02/14/2023] [Revised: 05/26/2023] [Accepted: 06/26/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Percutaneous renal cyst sclerotherapy (PRCS) as a treatment for renal cysts is usually performed with a high concentration of ethanol (≥ 90%). This study reviewed cases in which a lower concentration of ethanol (83%) was used for the procedure in dogs. METHODS Records of cases of renal cysts treated by sclerotherapy using 83% ethanol in dogs were reviewed. Outcomes of the treatment were evaluated by comparing volumes of renal cysts before the procedure and the volumes after treatment, using ultrasound images with the volume reduction rates classified as follows: < 50% of initial volume (failed); ≥ 50% but < 80% of initial volume (partial success); ≥ 80% but < 95% of initial volume (great success); ≥ 95% of initial volume (complete success). RESULTS Out of nine dog kidneys, renal cysts sclerotherapy with 83% ethanol achieved partial success in one kidney, great success in four, and complete success in the other four. No side effect was observed. The mean of the volume-reduction rates was 90.00 ± 11.00 while the minimum and maximum reduction rates were 65% and 100%, respectively. CONCLUSIONS The lower ethanol concentration (83%) is good for disinfecting kidneys in PRCS.
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Affiliation(s)
- Sanghyeon Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | - Jungmin Kwak
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Deokho Im
- Nel Animal Medical Center, Anyang 14065, Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea.
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2
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Zhou G, Li S, Jiang M, Zhou W, Yin J. Comparison of polidocanol sclerotherapy with laparoscopic deroofing in the management of pediatric symptomatic simple renal cysts: A long-term study. J Endourol 2021; 36:99-103. [PMID: 34269606 DOI: 10.1089/end.2021.0142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To compare the efficacy and safety of percutaneous polidocanol sclerotherapy and laparoscopic deroofing in the management of pediatric symptomatic simple renal cysts. METHODS Forty-six patients with symptomatic simple renal cysts (cyst size ≥ 4 cm) were treated either with polidocanol sclerotherapy (group A) or by laparoscopic deroofing (group B) between December 2009 and October 2019. The patients were re-evaluated at 1, 6, and 12 months and annually thereafter. RESULTS Twenty-one patients were treated with polidocanol sclerotherapy (group A) and 25 patients with laparoscopic deroofing (group B). The mean follow-up period was 58.7 months (14-107) in group A and 57.2 months (12-118) in group B. Complete regression was seen in 19 (90.5%) and 24 (96%) patients in groups A and B, respectively (p<0.05). Partial regression was documented in one patient each in group A (4.8%) and B (4%). In one group A patient, a laparoscopic deroofing was performed due to sclerotherapy failure after 27 months. The operation time, postoperative hospital stay, and cost were significantly less in group A than in group B (36.3±8.4 vs. 96.9±19.1, 19.7±2.4 vs. 56.0±8.6, and ¥8173±1343 vs. ¥14119±2021, respectively; p < 0.05). CONCLUSION Polidocanol sclerotherapy and laparoscopic deroofing were found to be equally effective interventions associated with minimal complications for pediatric symptomatic simple renal cysts. We recommend polidocanol sclerotherapy as the first option for children with symptomatic simple renal cysts and laparoscopic deroofing in cases of failed polidocanol sclerotherapy.
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Affiliation(s)
| | | | | | | | - Jianchun Yin
- Shenzhen Children's Hospital, 85113, urology, Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen 518000, Guangdong, P.R.China, Shenzhen, China, 518038;
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3
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Brown D, Nalagatla S, Stonier T, Tsampoukas G, Al-Ansari A, Amer T, Aboumarzouk OM. Radiologically guided percutaneous aspiration and sclerotherapy of symptomatic simple renal cysts: a systematic review of outcomes. Abdom Radiol (NY) 2021; 46:2875-2890. [PMID: 33544165 DOI: 10.1007/s00261-021-02953-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 11/30/2022]
Abstract
Simple renal cysts are common benign lesions of the kidney with up to 4% of patients developing symptoms necessitating intervention including pain and haematuria. We conducted a systematic review of the literature to determine the efficacy and safety of aspiration-sclerotherapy of symptomatic simple renal cysts. A systematic review using Cochrane guidelines was conducted on published literature from 1990 to 2020. RCTs, cohort studies and case series meeting the inclusion criteria were reviewed and cumulative analysis of outcomes was performed. A total of 4071 patients from 57 studies underwent aspiration ± sclerotherapy for their simple renal cysts. 87.7% of patients who had aspiration with sclerotherapy demonstrated 'treatment success' with a >50% reduction in cyst size and complete resolution of symptoms. 453 minor, transient complications occurred (11.2%) whilst a major complication rate of less than 0.1% (4 patients) was reported. Pooled analysis of all available current literature demonstrates that aspiration-sclerotherapy is a safe and effective first-line therapy for symptomatic simple renal cysts. Although we are unable to compare those undergoing aspiration alone to aspiration-sclerotherapy, it is evident the use of a sclerosing agent is integral to treatment success; however, the optimum agent, volume, injection frequency, and dwelling time are yet to be defined. Cyst size should be considered when discussing treatment options; however, we conclude it reasonable for aspiration-sclerotherapy to be used in the first instance in all cases of symptomatic simple renal cysts. Furthermore, we propose definitions of treatment outcome measures in order to allow direct comparative analysis across future studies.
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Affiliation(s)
- Dominic Brown
- Department of Urology, Broomfield Hospital, Chelmsford, UK.
| | - Sarika Nalagatla
- Department of Urology, University Hospital Monklands, Glasgow, UK
| | - Thomas Stonier
- Department of Urology, St George's Hospital, Tooting, London, UK
| | | | - Abdulla Al-Ansari
- Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Tarik Amer
- Department of Urology, University Hospital Monklands, Glasgow, UK
| | - Omar M Aboumarzouk
- Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- University of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow, Scotland, UK
- College of Medicine, Qatar University, Doha, Qatar
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Choi JD, Yoo TK, Kang JY, Moon KT, Kim JH, Ahn SH, Lee JH, Cho JM. A Comparative Study of Percutaneous Aspiration with Sclerotherapy and Laparoscopic Marsupialization for Symptomatic Simple Renal Cysts. J Laparoendosc Adv Surg Tech A 2020; 30:514-519. [PMID: 31928507 DOI: 10.1089/lap.2019.0745] [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: 11/12/2022] Open
Abstract
Background: Percutaneous aspiration with sclerotherapy (PAS) and laparoscopic marsupialization (LM) are minimally invasive treatment modalities for renal cysts. We aimed to compare the efficacy and cost/effectiveness of LM and PAS for the treatment of simple symptomatic renal cysts. Methods: Data were prospectively collected from three health care institutions in which 80 patients with symptomatic simple renal cysts underwent a single session of PAS with 95% ethanol (PAS group, n = 40) or underwent LM under general anesthesia (LM group, n = 40) between March 2012 and May 2016. We compared the patient profile, duration of procedure, duration of hospital stay, radiological and symptomatic success rates, treatment costs, and incidence of complications between the two groups. Results: At the 6-month follow-up, the radiological success rate in the LM group was significantly greater than that in the PAS group (97.5% versus 60%; P < .001). The symptomatic success rate was comparable in the two groups (95% versus 90%; P = .675). The treatment failure rate did not significantly differ between the two groups (5.0% versus 17.5%, P = .154). The mean total cost in the PAS and LM groups was 1256 USD and 2343 USD, respectively (P = .001). No significant between-group difference was noted regarding the overall complication rate (P = .615). Conclusions: Both LM and PAS are effective and safe procedures for the treatment of symptomatic simple renal cysts. A single session of PAS seems to be a cost-effective method for the management of symptomatic simple renal cysts.
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Affiliation(s)
- Jae Duck Choi
- Department of Urology, Eulji Genaral Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Tag Keun Yoo
- Department of Urology, Eulji Genaral Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Jung Yoon Kang
- Department of Urology, Eulji Genaral Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Kyong Tae Moon
- Department of Urology, Eulji Genaral Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Jung Hoon Kim
- Department of Urology, Hanil General Hospital, KEPCO Medical Foundation, Seoul, Republic of Korea
| | - Seung Hyun Ahn
- Department of Urology, Hanil General Hospital, KEPCO Medical Foundation, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Urology, National Police Hospital, Seoul, Republic of Korea
| | - Jeoung Man Cho
- Department of Urology, Eulji Genaral Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
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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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Ali TA, Abdelaal MA, Enite A, Badran YA. Ultrasound-guided percutaneous sclerotherapy of simple renal cysts with n-butyl cyanoacrylate and iodized oil mixture as an outpatient procedure. Urol Ann 2016; 8:51-5. [PMID: 26834402 PMCID: PMC4719512 DOI: 10.4103/0974-7796.162216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: The aim of this study was to evaluate the efficacy and safety of ultrasound guided percutaneous sclerotherapy of symptomatic simple renal cysts with n-butyl cyanoacrylate (NBCA) and iodized oil mixture as an outpatient single session procedure. Materials and Methods: A total of ninety two patients with 100 symptomatic simple renal cysts (larger than 5 cm) were treated by ultrasound (US)-guided percutaneous aspiration and injection of NBCA and iodized oil mixture. The patients (68 men and 24 women, mean age, 42.4 ± 10.5 years) were treated with as out-patients. The volume of the treated cysts was calculated with periodic noncontrast enhanced CT examinations 3, 6 and 9, months after the procedure. The procedure was considered successful at follow-up CT when there was total ablation or greater than 80% reduction of size with resolution of symptoms, respectively. Failure was defined as less than 80% reduction and/or persistent symptoms. Results: The sclerotherapy was technically successful in all patients. The diameter of the cysts ranged between 5.5 and 13.5 cm (mean, 8.8 ± 1.4 cm), and 1.5 and 3.8 cm (mean, 2.1 ± 0.4 cm) before and after sclerotherapy, respectively (P < 0.001). Average diameter reduction was 83.7% during the follow-up period. The mean follow- up lasted 7.1 months (3–11 months). Flank pain resolved in 86 of 92 symptomatic patients (93.48%). In six patients, the symptoms decreased slightly. The procedure was successful in 98 of 100 cysts (98%), demonstrated by follow-up CT. The only two failed cyst was larger than 10 cm in diameter and don’t required any further treatment. We did not observe any procedure related complications. Conclusion: Ultrasound guided percutaneous sclerotherapy with NBCA and iodized oil mixture for management of symptomatic simple renal cysts was found to be a real time, effective, safe, well tolerated, alternative and simple technique that can be carried out by urologists as an outpatient procedure.
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Affiliation(s)
- Tamer A Ali
- Department of Urology, Al-Azhar Faculty of Medicine, Cairo, Egypt
| | | | - Ashraf Enite
- Department of Radiology, Al-Azhar Faculty of Medicine, Cairo, Egypt
| | - Yasser A Badran
- Department of Urology, Al-Azhar Faculty of Medicine, Cairo, Egypt
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Dell'Atti L. Comparison between the use of 99% ethanol and 3% polidocanol in percutaneous echoguided sclerotherapy treatment of simple renal cysts. Urol Ann 2015; 7:310-4. [PMID: 26229316 PMCID: PMC4518365 DOI: 10.4103/0974-7796.152026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 04/10/2014] [Indexed: 11/04/2022] Open
Abstract
AIM In this study, we compared and valued efficacy and safety of percutaneous echoguided sclerotherapy (PES) using 3% polidocanol with that using 99% ethanol in the treatment of patients with simple renal cysts. MATERIALS AND METHODS PES was performed for 65 simple renal cysts. Under ultrasonographic guidance the cyst was punctured using an 18 gauge needle. Sclerotherapy was performed with ethanol in 55% (36/65) of cases and with polidocanol in the remaining 45% (29/65). Patients were followed up with an ultrasound examination at 4 months, 8 months, and then at yearly intervals. A reduction of 50% or greater in cyst diameter was considered successful. RESULTS The median followup period for the ethanol and polidocanol groups was 24.6 and 22.8 months, respectively. The successful outcome ratio of the polidocanol group was significantly higher (90% vs. 61%, respectively) than the one of the ethanol group (P = 0.003). The partial regression of the ethanol and polidocanol groups were 6% versus 7%, respectively. The failure ratio of the polidocanol group was significantly lower (3% vs. 33%, respectively) than that of the ethanol group (P = 0.004). Neither infectious complications nor hyperthermia occurred in all treated cases. However, these methods are not completely free from symptoms. All these symptoms disappeared few hours after the procedure. CONCLUSIONS Polidocanol is a safe and effective sclerosing agent for renal cysts, with superior clinical results than ethanol. Therefore, polidocanol can be an alternative to ethanol in sclerotherapy of renal cysts.
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Affiliation(s)
- Lucio Dell'Atti
- Department of Urology, Arcispedale "S. Anna", Cona 44124, Ferrara, Italy
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8
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Symptomatic abdominal simple cysts: is percutaneous sclerotherapy with hypertonic saline and bleomycin a treatment option? Gastroenterol Res Pract 2015; 2015:489363. [PMID: 25878660 PMCID: PMC4386601 DOI: 10.1155/2015/489363] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/27/2015] [Accepted: 02/27/2015] [Indexed: 01/26/2023] Open
Abstract
Aim. To evaluate the feasibility of percutaneous sclerotherapy of symptomatic simple abdominal cysts, using hypertonic saline and bleomycin, as an alternative to surgery. Materials and Methods. This study involved fourteen consecutive patients (ten women, four men, mean age: 59.2 y) with nineteen symptomatic simple cysts (liver n = 14, kidney n = 3, and adrenal n = 2) treated percutaneously using a modified method. Initially CT-guided drainage was performed; the next day the integrity of the cyst/exclusion of extravasation or communications was evaluated under fluoroscopy, followed by two injections/reabsorptions of the same quantity of hypertonic NaCl 15% solution and three-time repetition of the same procedure with the addition of bleomycin. The catheter was then removed; the patients were hospitalized for 12 hours and underwent follow-ups on 1st, 3rd, 6th, and 12th months. Cyst's volumes and the reduction rate (%) were calculated in each evaluation. Results. No pain or complications were noted. A significant cyst's volume reduction was documented over time (P < 0.001). On the 12th month 17 cysts disappeared and two displayed a 98.7% and 68.9% reduction, respectively. Conclusion. This percutaneous approach constitutes a very promising nonsurgical alternative for patients with symptomatic simple cyst, without complications under proper precautions, leading to eliminating the majority of cysts.
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Yonguc T, Sen V, Aydogdu O, Bozkurt IH, Yarimoglu S, Polat S. The comparison of percutaneous ethanol and polidocanol sclerotherapy in the management of simple renal cysts. Int Urol Nephrol 2015; 47:603-7. [DOI: 10.1007/s11255-015-0953-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/08/2015] [Indexed: 10/23/2022]
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10
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Monville H, Wagner L, Dibo D, Soustelle L, Muyshondt C, Droupy S, Costa P. Sclérothérapie percutanée à l’éthanol des kystes rénaux symptomatiques : résultats à 4 ans. Prog Urol 2014; 24:353-8. [DOI: 10.1016/j.purol.2013.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 10/24/2013] [Accepted: 11/03/2013] [Indexed: 10/25/2022]
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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. [DOI: 10.1089/end.2011.0559] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mayank Agarwal
- Department of Surgery, SN Medical College, Agra, Uttar Pradesh, India
| | - Madhu S. Agrawal
- Department of Surgery, SN Medical College, Agra, Uttar Pradesh, India
| | - Ruchi Mittal
- Department of Surgery, SN Medical College, Agra, Uttar Pradesh, India
| | - Vivek Sachan
- Department of Surgery, SN Medical College, Agra, Uttar Pradesh, India
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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. [DOI: 10.1111/j.1464-410x.2011.10847.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Renal cysts are a common imaging finding. Although most cysts never have symptoms, some cause pain, collecting system compression, hematuria, hypertension, and secondary infection. The mere presence of a cyst is not an indication for intervention, but treatment may be indicated in symptomatic patients or those with secondary obstruction. Urinomas generally are a contained collection of urine outside of the normal pathways where urine travels. As such, urinomas can arise anywhere from the upper abdomen down into the low pelvis and have a variety of etiologies. Ureteral obstruction with forniceal rupture and trauma (blunt, penetrating, or iatrogenic) are the most common causes of urinomas. When urinomas arise spontaneously, the likely cause varies with the patient's age. Blunt or penetrating trauma can cause perinephric urinomas by two mechanisms-direct disruption of the pelvis or collecting system or by degeneration of nonviable tissue. These urinomas are often perinephric, but can also occur in a subcapsular location. This review will discuss diagnosis, classification, and treatment of renal cysts and urinomas.
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Affiliation(s)
- Jessica Lee
- Mallinckrodt Institute of Radiology, St. Louis, Missouri
| | - Michael Darcy
- Mallinckrodt Institute of Radiology, St. Louis, Missouri
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CT-Guided Sclerotherapy With Ethanol Concentration Monitoring for Treatment of Renal Cysts. AJR Am J Roentgenol 2011; 196:W78-82. [PMID: 21178037 DOI: 10.2214/ajr.10.4671] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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15
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Choi YD, Ham WS, Kim WT, Cho KS, Lee JH, Cho SY, Seo JW, Jin OH. Clinical experience of single-session percutaneous aspiration and OK-432 sclerotherapy for treatment of simple renal cysts: 1-year follow-up. J Endourol 2009; 23:1001-6. [PMID: 19459755 DOI: 10.1089/end.2008.0137] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To evaluate the efficacy and safety of single-session OK-432 sclerotherapy for the treatment of renal cysts. MATERIALS AND METHODS From October 2005 to November 2006, 48 patients (61 simple renal cysts) were included in the study. Indications were determined as flank discomfort (n = 37) or patient reassurance due to increasing size (n = 11). The simple renal cysts were aspirated under ultrasonography (US), at which point OK-432 was injected into the cyst. Follow-up was performed with US or computed tomography scan every 3 months until 1 year. Complete regression of the renal cyst or more than 70% reduction in size with no symptoms indicated a successful treatment. RESULTS Among 61 renal cysts of 48 patients, the overall success rate was 98.4%. Complete regression occurred in 46 cysts (75.4%), and more than 90% reduction in size occurred in 6 cysts (9.8%). A size reduction of 80% to 90% and 70% to 80% occurred in five (8.2%) and three cysts (4.9%), respectively. A size reduction less than 70% occurred in only one cyst (1.6%). The success of cyst regression was correlated with cyst volume. Clinical symptoms resolved in 100% of patients with symptomatic cysts, and there was no enlargement of the aspirated cysts at the 1-year follow-up. After the procedure, there were only some minor complications, such as mild fever, flank pain, and leukocytosis, which subsided with the conservative treatment. CONCLUSIONS Percutaneous OK-432 sclerotherapy is simple, safe, and effective, and it can be an alternative first-line therapy for simple renal cysts.
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Affiliation(s)
- Young Deuk Choi
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea.
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D'Ippolito G, Torres LR, Ribeiro ACR, Roque ADJ, Ortiz V, Ajzen S. Alcoolização percutânea de cistos renais: revisão da literatura e apresentação de resultados. Radiol Bras 2009. [DOI: 10.1590/s0100-39842009000400007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Demonstrar a eficácia e os resultados práticos da alcoolização percutânea de pacientes com cistos renais simples sintomáticos. MATERIAIS E MÉTODOS: Foram revistos os resultados obtidos em dez pacientes com cistos renais simples sintomáticos (oito homens e duas mulheres), com idade entre 28 e 72 anos (média de 55 anos), submetidos a pelo menos duas alcoolizações percutâneas. A indicação do procedimento foi dor no flanco refratária nos dez pacientes, sete deles com algum grau de hidronefrose pela localização parapiélica do cisto. O volume aspirado variou entre 20 e 1.300 ml (média de 200 ml). O tempo médio de seguimento após o procedimento foi de sete meses. O procedimento foi dirigido por ultrassonografia em dois casos e por tomografia computadorizada em oito. O tempo de internação variou entre 24 e 72 horas. Foi considerado sucesso completo do tratamento o desaparecimento do cisto, e parcial a redução maior que 50%. RESULTADOS: Durante o seguimento houve redução completa do cisto em sete pacientes e redução parcial em três. Em nenhum caso foram registradas complicações e os pacientes toleraram bem o procedimento. CONCLUSÃO: A alcoolização percutânea de cistos renais sintomáticos é um procedimento seguro, efetivo e pouco invasivo e com resultados semelhantes aos obtidos por outros autores.
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Affiliation(s)
- Giuseppe D'Ippolito
- Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital São Luiz, Brasil
| | - Lucas Rios Torres
- Universidade Federal de São Paulo/Escola Paulista de Medicina; Hospital São Luiz, Brasil
| | | | | | - Valdemar Ortiz
- Universidade Federal de São Paulo/Escola Paulista de Medicina, Brasil
| | - Sergio Ajzen
- Universidade Federal de São Paulo/Escola Paulista de Medicina
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Omerović S, Zerem E. Alcohol sclerotherapy in the treatment of symptomatic simple renal cysts. Bosn J Basic Med Sci 2009; 8:337-40. [PMID: 19125704 DOI: 10.17305/bjbms.2008.2893] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate the results of percutaneous drainage with single-session alcohol sclerotherapy in the treatment of symptomatic simple renal cysts. Thirty patients (16 men and 14 women, average age 54,7+/-11,3 years) with simple renal cysts were treated by ultrasound guided percutaneous aspiration and single-session alcohol sclerotherapy. Patient demographics, clinical characteristics, treatment outcome and complications were analyzed. Average reduction of cyst volume was 91,2%. Complete and partial resolution occurred in 10 (33%) and 14 (47%) cysts, respectively. Six cases were defined as failure with reduction of cyst volume <80%. Flank pain improved in all patients, regardless of complete or partial resolution. Minor complications occurred in 8 patients. The hospital stay was one day for all patients. Treatment of simple renal cysts is indicated when the cysts are sufficiently large and cause complaints or when associated with complications. Percutaneous treatment with alcohol sclerotherapy of benign renal cysts can be performed safely and effectively.
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Affiliation(s)
- Safet Omerović
- Department of Urology, General Hospital Mostar, Mostar, Bosnia and Herzegovina
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Ham WS, Lee JH, Kim WT, Yu HS, Choi YD. Comparison of Multiple Session 99% Ethanol and Single Session OK-432 Sclerotherapy for the Treatment of Simple Renal Cysts. J Urol 2008; 180:2552-6. [DOI: 10.1016/j.juro.2008.08.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2008] [Indexed: 10/21/2022]
Affiliation(s)
- Won Sik Ham
- Departments of Urology and the Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Hyoung Lee
- Departments of Urology and the Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Won Tae Kim
- Departments of Urology and the Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Song Yu
- Departments of Urology and the Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young Deuk Choi
- Departments of Urology and the Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
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CHO DS, AHN HS, KIM SI, KIM YS, KIM SJ, JEON GS, WON JH. Sclerotherapy of renal cysts using acetic acid: a comparison with ethanol sclerotherapy. Br J Radiol 2008; 81:946-9. [DOI: 10.1259/bjr/41664864] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Symptomatic simple renal cyst: comparison of continuous negative-pressure catheter drainage and single-session alcohol sclerotherapy. AJR Am J Roentgenol 2008; 190:1193-7. [PMID: 18430831 DOI: 10.2214/ajr.07.2867] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate whether continuous percutaneous catheter drainage with negative pressure yields better results than single-session alcohol sclerotherapy in the management of symptomatic simple renal cysts. SUBJECTS AND METHODS Eighty-five patients with 92 simple renal cysts were randomly assigned to two groups in a prospective controlled trial. One group was treated with sonographically guided continuous catheter drainage with negative pressure and the other group with single-session alcohol sclerotherapy. Patient demographics, clinical characteristics, treatment outcome, and complications were analyzed. RESULTS The initial volume of the cysts did not differ significantly between the groups, but the final volume was significantly smaller in the continuous drainage group (p = 0.026). During the 24-month follow-up period, 37 (40%) of the cysts disappeared completely: 24 (52%) of the 46 cysts in the drainage group and 13 (28%) of the 46 cysts in the sclerotherapy group (p = 0.033). In the sclerotherapy group, the probability of disappearance of the cysts was highly dependent on cyst size, being less for giant cysts (p = 0.01). Cyst size was not a significant factor in probability of disappearance in the drainage group (p = 0.15). The probability of disappearance of giant cysts (volume > 500 mL) differed significantly between the groups (p = 0.009), but there was no difference in probability of disappearance of moderately large cysts (p = 0.16). Three of 14 patients with giant cysts in the drainage group and 10 of 13 such patients in the sclerotherapy group had recurrences that necessitated additional treatment (p = 0.007). They were successfully treated with continuous catheter drainage. CONCLUSION Continuous catheter drainage with negative pressure is more efficient than single-session alcohol sclerotherapy in the management of giant cysts. For moderately large cysts, the two methods have similar results.
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Park SJ, Ham WS, Kim WT, Lee DH, Cho SY, Cho KS, Choi YD. Treatment of Simple Renal Cysts by Percutaneous Aspiration and OK-432 Sclerotherapy. Korean J Urol 2008. [DOI: 10.4111/kju.2008.49.10.917] [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)
- Sung Jin Park
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Won Sik Ham
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Won Tae Kim
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Hoon Lee
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Soung Yong Cho
- Department of Urology, Inje University College of Medicine, Ilsan, Korea
| | - Kang Su Cho
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young Deuk Choi
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
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Kwon SH, Oh JH, Seo TS, Park HC. Efficacy of single-session percutaneous drainage and 50% acetic Acid sclerotherapy for treatment of simple renal cysts. Cardiovasc Intervent Radiol 2007; 30:1227-33. [PMID: 17914652 DOI: 10.1007/s00270-007-9176-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Revised: 07/15/2007] [Accepted: 09/11/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the efficacy and long-term results of single-session 50% acetic acid sclerotherapy for the treatment of simple renal cysts, and to compare the therapeutic results of 5 and 20 min sclerosant dwell techniques. METHODS During the past 9 years, 50% acetic acid sclerotherapy was performed on 67 cysts in 66 patients. An acetic acid volume corresponding to a mean of 23% of the aspirated cyst volume was injected into the cysts. A 20 min dwell time with position changes was performed in 32 cysts (31 patients; group I) and 8% of volume for a 5 min dwell time in 35 cysts (35 patients; group II). Three- and 6-month sonographic or CT follow-up was performed for a minimum of 1 year. Complete regression was defined as no remaining cyst measurable on sonography with or without a scar at the renal cortex. Partial regression was defined as a decreased cyst volume compared with that before sclerotherapy. The Mann-Whitney U-test was used to compare the therapeutic results between the two groups. RESULTS For 67 simple renal cysts, complete regression on follow-up was observed in 21 of 32 cysts (66%; group I) and 22 of 35 cysts (63%; group II); the remaining 24 cysts all showed partial regression. The partial reduction rate of the cyst's volume was 97.4% (91.3-99.4%) in group I and 96.9% (90.8-99.5 %) in group II. There were no procedure-related major complications, and no statistically significant differences in the complete regression and partial volume reduction rates between the two groups (p > 0.05). CONCLUSION Fifty percent acetic acid is an effective and safe sclerosing agent for simple renal cysts. Fifty percent acetic acid sclerotherapy with a 5 min sclerosant dwell time, using a volume of about 10% of the aspirated volume, is sufficient for satisfactory results of simple renal cyst sclerotherapy.
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Affiliation(s)
- Se Hwan Kwon
- Department of Diagnostic Radiology, Kyung Hee University Hospital, Hoeki-dong 1, Dongdaemun-gu, Seoul 130-702, Republic of Korea
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Mohsen T, Gomha MA. Treatment of symptomatic simple renal cysts by percutaneous aspiration and ethanol sclerotherapy. BJU Int 2005; 96:1369-72. [PMID: 16287460 DOI: 10.1111/j.1464-410x.2005.05851.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report our experience with the use of 95% ethanol as sclerotherapy for symptomatic simple renal cysts. PATIENTS AND METHODS Sixty patients with 64 symptomatic simple renal cysts were treated by ultrasonography (US)-guided percutaneous aspiration and injection of 95% ethanol (31 men and 29 women, mean age 46 years, SD 22). The main presentation was renal pain in 34 patients, renal mass in nine, hypertension in 11 and haematuria in six; 24 cysts were on the right, 32 on the left and four bilateral. Patients were evaluated after 1 month and then every 6 months by clinical assessment, US and intravenous urography. Success was defined as complete when there was total ablation of the cyst and partial when there was a recurrence of less than half the original cyst volume with the resolution of symptoms. Failure was defined as the recurrence of more than half of cyst volume and/or persistent symptoms. RESULTS After aspiration and ethanol sclerotherapy, there was microscopic haematuria in two patients and low-grade fever (<38.3 degrees C) in two, but no major complications. During a mean (range) follow-up of 19 (14-40) months there was complete cyst ablation in 54 cysts and partial resolution in 10. Pain disappeared or was much improved in all patients. After cyst ablation hypertension was well controlled with no medication in all 11 hypertensive patients and haematuria disappeared in all six affected patients. CONCLUSIONS Ethanol sclerotherapy for symptomatic simple renal cysts is simple, minimally invasive and highly effective. We recommend it as the first therapeutic option in these patients.
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Affiliation(s)
- Tarek Mohsen
- Department of Radiology, Mansoura Urology and Nephrology Center, Mansoura University, Egypt
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Lin YH, Pan HB, Liang HL, Chung HM, Chen CY, Huang JS, Chou KJ, Chen CKH, Lai PH, Yang CF. Single-Session Alcohol-Retention Sclerotherapy for Simple Renal Cysts: Comparison of 2- and 4-Hr Retention Techniques. AJR Am J Roentgenol 2005; 185:860-6. [PMID: 16177401 DOI: 10.2214/ajr.04.1219] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objectives of our study were to evaluate the feasibility of ethanol sclerotherapy in treating simple renal cysts with prolonged ethanol retention and to compare the therapeutic results of 2- and 4-hr retention techniques. MATERIALS AND METHODS We retrospectively reviewed 36 renal cysts in 33 patients treated by ethanol sclerotherapy with a single-session single-injection technique during the past 6 years. After complete aspiration of the cystic fluid, 95% ethanol was injected into the cyst and was retained for 4 hr in 14 cysts (group 1) and for 2 hr in 22 cysts (group 2). The average maximal diameter and aspirated volume of the cysts were 8.3 cm and 223 mL in group 1 patients and 7.9 cm and 167 mL in group 2, respectively. The ablated cysts were followed up regularly by sonography, CT, or both at 3- to 6-month intervals for at least 1 year. The nonparametric Mann-Whitney U test was used to compare differences in characteristics, treatment results, and laboratory data of the subjects in the two groups. The level of statistical significance was set at a p value of less than 0.05. RESULTS Technically, all the patients tolerated the procedures. One patient had gross hematuria 10 days after the procedure. She underwent surgical deroofing treatment and was excluded in the later statistical analysis. After sclerotherapy, 14 cysts disappeared completely and 16 cysts showed marked regression with residual maximal diameter of less than 3 cm. The overall volume reduction rate was 97.6% in all 35 cysts. The mean residual longest diameters and average volume reduction rates of the treated cysts were 1.9 cm and 97.9% in group 1 patients and 1.1 cm and 97.3% in group 2 patients, respectively, which showed no statistical significance of volume reduction rate with a p value 0.149. CONCLUSION The single-session prolonged ethanol-retention technique is safe and efficacious for the treatment of renal cysts. There is no statistical difference in therapeutic efficacy between 2- and 4-hr ethanol-retention techniques.
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Affiliation(s)
- Yih-Huie Lin
- Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung First Rd., Kaohsiung, Taiwan 813, ROC
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Nalçaci S, Cankurtaran M, Sümer H, Hazirolan T, Arioğul S. A giant renal cyst in a 89-year-old patient with a malign clinic. Int Urol Nephrol 2004; 35:149-51. [PMID: 15072485 DOI: 10.1023/b:urol.0000020292.80664.a6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Serdar Nalçaci
- Faculty of Medicine, Department of Internal Medicine, Hacettepe University, Turkey
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Singh I, Sharma D, Singh N. Retroperitoneoscopic Deroofing of a Giant Renal Cyst in a Solitary Functioning Hydronephrotic Kidney With a 3-port Technique. Surg Laparosc Endosc Percutan Tech 2003; 13:404-8. [PMID: 14712107 DOI: 10.1097/00129689-200312000-00014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To explore the safety and feasibility of performing retroperitoneoscopic renal cystectomy in a case of massive giant renal cyst in a solitary hydronephrotic renal unit. We have described the retroperitoneal three-trocar technique. The role of laparoscopic renal cyst ablation in giant symptomatic renal cysts and non-polycystic kidney disease has been discussed. The patient was successfully managed by retroperitoneoscopic deroofing using a three-port technique. The operating room time was 90 minutes and her hospital stay lasted 54 hours. The fluid cytology and cyst histology were negative for tumor. Complete resolution of the cyst was noted on a follow-up ultrasound done after 2 months. Currently at 9-month follow up, the patient is ultrasonographically free of any cyst recurrence or hydronephrosis. The retroperitoneal approach is feasible for marsupializing giant symptomatic renal cysts and appears to be safe for solitary symptomatic renal units too. It shortens the overall operating time and avoids the complications and demerits of transperitoneal access.
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Affiliation(s)
- Iqbal Singh
- Department of Surgery, University College of Medical Sciences, University of Delhi & GTB Hospital, India.
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