Evaluation of renal cyst treatment using retroperitoneal laparoscopic decortication

Abstract

Introduction: Renal cysts are a common disease of the renal parenchyma. The management options include percutaneous aspiration with or without sclerotherapy, open surgery, and the laparoscopic decortication of the renal cyst. Laparoscopic renal cyst decortication is a safe and effective alternative with a high success rate. This study aimed to evaluate renal cyst treatment by retroperitoneal laparoscopic decortication.

Methods: This was a prospective study of patients with an asymptomatic renal cyst size greater than 60 mm or a symptomatic renal cyst size less than 60 mm in their greatest dimension. The patients underwent retroperitoneal laparoscopic decortication and were admitted to the University Hospital, Can Tho General Hospital (Viet Nam), and Can Tho Central General Hospital (Viet Nam) from September 2018 to May 2020. The renal cysts were localized and characterized by ultrasonography and computed tomography (CT). The symptomatic success rate, radiologic success rate, and any complications as part of the procedure were noted. Each patient was reassessed with clinical and ultrasonography examinations at 3 months postoperatively.

Results: 33 patients underwent retroperitoneal laparoscopic cyst decortication. This included 11 males (33.3%) and 22 females (66.7%). The mean age of the patients was 58.48 ± 9.36 years. Flank pain was a common clinical symptom at presentation in all patients. Most of the cysts were located in the left kidney (39.4%), in the lower pole (54.6%), and in a single cyst (87.9%). The mean cyst diameter was 80.09 ± 27.03 mm. The cysts were classified as I using the Bosniak classification. The mean operative time was 69.39 ± 16.94 minutes. The operative time in the patients with a cyst diameter ≥ 60 mm was statistically significantly longer than in the patients with a cyst diameter < 60 mm (p = 0.004). The mean hospital stay time was 8.24 ± 2.84 days. Symptomatic success was achieved in 90.1% of patients and radiographic success on ultrasonography was achieved in 84.8%. The operation was successfully completed by laparoscopy in all cases.

Conclusion: Retroperitoneal laparoscopic cyst decortication is effective for the treatment of renal cysts. The operation was successfully completed via laparoscopy in all cases.