Long-Term Durability Of Laparoscopic Decortication Of Symptomatic Renal Cysts

UroToday.com - Aspiration and sclerosis remain the primary management for symptomatic simple renal cysts. However, as these investigators have shown, laparoscopic decortication is the management of choice for those cysts too large to be managed by aspiration or for those that are recurrent. In this group of 45 patients reviewed over a 10-year period of time, laparoscopic decortication of symptomatic simple renal cysts was performed using a well accepted technique, including renal cyst wall excision and fulguration of the epithelial lining.

In this group of patients, over half of them had failed a previous cyst aspiration with injection of sclerosant. However, this may have been due to the very large cyst size, which approached or exceeded 10 cm in the majority of the patients, and was close to 20 cm in several patients.

Using both a pre- and post-operative objective pain analog scale assessment, they showed symptomatic resolution in 91% of their patients over a median follow-up of 52 months. In addition, computed tomography was used for radiologic assessment, and success in these patients was determined if there was no recurrence of the cyst, and this was achieved in 96% of patients, again with a median follow-up of 39 months.

Therefore, laparoscopic cyst decortication appears to be an effective and durable treatment option for symptomatic simple renal cysts, especially those of unusually large size. This may not be an unreasonable primary alternative for patients who have simple symptomatic renal cysts larger than 10 cm in size.

S. Atug, S.V. Burgess, G. Ruiz-Deya, F. Mendes-Torres, E.P.
Castle and R. Thomas
Urology, 68(2);272-275, 2006.

Reviewed by UroToday.com Contributing Editor Elspeth M. McDougall, MD, FRCSC

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