Laparoscopic marsupialization of the painful polycystic kidney.
Autosomal dominant polycystic kidney disease patients may present with intractable cyst pain. Common practice has been to attempt percutaneous drainage of the affected cyst and, if unsuccessful, to offer open surgical decortication. We report laparoscopic renal cyst marsupialization for painful autosomal dominant polycystic kidney disease among 6 patients who failed prior percutaneous drainage. Mean surgical and anesthesia times were 3 hours and 3 hours 35 minutes, respectively. Mean blood loss was 140 cc. Median intervals to ambulation, oral intake and hospital discharge were 1.5, 1.5 and 3 days, respectively. All 6 patients reported pain relief with followup of 6 to 40 months. These results suggest that laparoscopic marsupialization of painful autosomal dominant polycystic kidney disease is technically feasible and safe, and the laparoscopic approach may offer a palliative option for patients in whom prior percutaneous management failed.
Teichman
J M
JM
Department of Urology, University of Minnesota Hospital and Clinic, Minneapolis.
Hulbert
J C
JC
D016063:Blood Loss, Surgical; D004322:Drainage / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010148:Intractable Pain / Q000209:etiology; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies