Purpose: to investigate the efficacy of laparoscopic excisions of the renal cysts.
Renal cysts are very common and mostly benign lesions, that appear to be either a component of different syndromes or separately, the etiology of which mostly unknown. Solitary cysts usually seen in patients at the age of 40-50 years and once appeared it tend to increase by size later, thus it need to be monitored by annual ultrasound investigation. Large cysts can cause unilateral flank pain or discomfort, hypertension (in cases of intimate location with the renal hilum), fever if cyst infection occurs. Forementioned symptoms are the indication for surgical intervention. There are a few methods of surgical treatments, such as fine-needle puncture, laparoscopic or open excision of cyst wall.
Considering the fine-needle puncture and laparoscopic excision both have high rates of efficacy in case of solitary (one-chambered) cysts, but the efficacy of the former decreases in case of complex cysts (multiple chambers), due to the difficulties during the infusion of sclerosing agents into the all cavities. But in laparoscopic approach the efficacy is the same in case of simple or complex cysts. One more advantage of laparoscopic approach is the opportunity to take histologic material.
The cases of 37 patients, that underwent laparoscopic excision of renal cysts were investigated retrospectively (25 male and 12 female patients). Average age of patients was 53.4 ±8.48 years. 25 patients had unilateral flank pain/ discomfort, 7 patients noticed increase of blood pressure and the rest 5 patients didn’t have any complaints. In 7 cases cyst was located on the right and in 30 cases – on the left. In 5 cases were complex cysts. All cysts were classified as Bosniak 1-2. Average size of cysts was 9.1±2.1 cm. In all cases excised wall was sent to histologic evaluation.
Duration of surgery was 63.1±15.4 min. Patients were underwent ultrasound investigation for 6 months. Signs of recurrence were not observed during the survey. Efficacy was 100 %. Patients were discharged at third postoperative day. All cysts were histologically benign.
Laparoscopic excision of renal cysts is safe, effective and minimally invasive surgical approach. The advantages are: