Laparoscopic Treatment of Simple Renal Cyst

Abstract

Introduction. Renal cysts are a very common condition that can occur at any age from newborn to the elderly. Simple renal cysts are generally diagnosed incidentally on sonography, computed tomography (CT) scans, or intravenous urography performed for urinary tract or other abdominal problems.Patients and Method.During the period of Nov 2011 to Oct 2012, 30 patients (mean age 60 years; range 42–77 years; 17 men and 13 women) with symptomatic, voluminous renal cysts were encountered in this study. The size of the cyst was ranging between 10 - 17 mm (mean 14mm). All patients were studied with ultrasound, excretory urography, and contrast enhanced CT scans. In this series, all cysts were of type I according to the Bosniak classification.Transperitoneal laparoscopic deroofing technique was used.Results.The operation was successfully completed laparoscopically in all cases with no conversion to open surgery. There were no major perioperative complications. Two cases only developed ileus postoperatively and stayed for 3 days, this was due to some colonic adhesions that required more dissection. Hospital stay was 2days (range, 1-3 days). After 12 months period of follow up, clinical improvement (disappearance of symptoms) was observed in 25 patients (84.4%). There were 4 patients who continued had lumber pain post operatively and this could be due to that the patient's symptom already due to backache and not related to the cyst. Only 1 patient had increased hydronephrosis that required percutaneous nephrostomy.Conclusions.Laparoscopic deroofing of large simple renal cysts is an efficacious, safe and less invasive method of treatment and is recommended as a primary treatment for symptomatic simple renal cysts.