SAFETY AND LONG-TERM OUTCOMES OF TRANS-PERITONEAL LAPAROSCOPIC RENAL CYST DECORTICATION FOR THE TREATMENT OF SYMPTOMATIC SIMPLE RENAL CYST

Ismail Hama Amin Agha Wias a, Sarwar Noori Mahmood aSaman Anwar Wahid b, and Basheer Anwer Bakr c



a Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 
b Sulaymaniyah General Teaching Hospital, Urology Department, Sulaymaniyah, Iraq.
c Kirkuk General Hospital, Urology Department, Iraq.
 
Submitted: 5/3/2019; Accepted: 5/8/2019; Published: 21/9/2019

ABSTRACT


Background 

Laparoscopic decortication of symptomatic simple renal cyst has been shown to be an effective durable treatment with minimal complications.


Objectives

To assess the efficacy, safety, and long-term outcomes of transperitoneal laparoscopic decortication of symptomatic simple renal cysts. 


Patients and Methods

Thirty-six consecutive patients (20 men; 16 women) who underwent transperitoneal laparoscopic decortication of simple renal cysts at our department between January 2015 and June 2017 were enrolled in the study. The main indication for surgery was flank pain in 24 (66.5%), urinary tract obstruction in 5 (14%), and cyst enlargement on follow up in 7 (19.5%) patients. Only patients with symptomatic simple cysts more than 5 cm (Bosniak I & II) were included in this study, while patients with complicated cysts (Bosniak III & IV) were excluded. The patients were followed up for symptomatic and radiological success. Symptomatic success was defined as a significant pain improvement (using a visual analog pain scale), and procedure success was defined as no recurrence of the cyst and complete pain relief. 


Results

All patients had their cysts completely removed laparoscopically with a mean operative time of 47 minutes without major perioperative complications or conversion to open surgery. The mean blood loss was 65 ml, and the mean patient’s hospitalization was 1.3 days. After a mean follow-up of 11.4 months, radiological and symptomatic success was 87.5% and 94%, respectively. Patients having upper pole cyst significantly had longer operative duration and more postoperative pain score compared to the middle and lower pole cysts p-value < 0.05.


Conclusion

Transperitoneal laparoscopic simple cyst decortication is safe and effective with high long-term symptomatic and radiologic success rate.



KEYWORDS

Transperitoneal laparoscopy, Simple renal cyst, Decortication, Symptomatic renal cyst.