Long-term durability of laparoscopic decortication of symptomatic renal cysts.
OBJECTIVE
To assess the long-term results of patient symptoms and radiologic outcomes of laparoscopic renal cyst decortication in the treatment of symptomatic simple renal cysts. Renal cysts are common in the adult population. Symptomatic renal cysts have traditionally been treated by percutaneous aspiration with or without injection of sclerosant agents; however, this has a high rate of recurrence.


METHODS
From April 1994 through July 2005, 45 patients underwent laparoscopic decortication of symptomatic simple renal cysts with renal cyst wall excision and fulguration of the epithelial lining. Complex renal cysts were excluded. Of the 45 patients, 24 (53.3%) had undergone previous cyst aspiration with injection of sclerosant material for intended ablation. The Wong-Baker pain scale was used to assess the preoperative and postoperative pain scores. Radiologic success was indicated as no recurrence on the most recent computed tomography scan.


RESULTS
Of the 45 procedures, 44 were completed laparoscopically. One patient (1.8%) underwent open conversion because of excessive bleeding. The mean operative time was 89 minutes (range 48 to 170). Symptomatic success was achieved in 91.1% of patients, with a median follow-up of 52 months (range 3 to 132), and radiographic success was achieved in 95.5% of patients, with a median follow-up of 39 months (range 3 to 96).


CONCLUSIONS
Long-term follow-up has confirmed that laparoscopic cyst decortication is an effective and durable treatment option for symptomatic simple renal cysts during long-term follow-up. The greater and durable success rates of this minimally invasive technique may favor this treatment option over other treatment modalities.
Atug
Fatih
F
Department of Urology, Center for Minimally Invasive Urologic Surgery, Tulane University Health Sciences Center, New Orleans, Louisiana 70112, USA.
Burgess
Scott V
SV
Ruiz-Deya
Gilberto
G
Mendes-Torres
Freddy
F
Castle
Erik P
EP
Thomas
Raju
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013997:Time Factors