Laparoscopic transperitoneal renal cyst decortication

Abstract

The aim of this study was to report our experience with the llaparoscopic transperitoneal treatment of simple renal cysts, to analyze the immediate and long-term clinical outcomes, and to evaluate the efficacy and safety of this miniinvasive surgical technique. Between 2009 and 2014 we diagnosed and treated a total of 48 patients with symptomatic simple renal cysts. The diagnosis was set up by ultrasound (US) and/or computed tomography (CT) examination. All cases were managed by transperitoneal laparoscopic cyst decortication. Demographic data, perioperative blood loss, duration of operative procedure, length of hospital stay and peri- and postoperative complications were analyzed. Follow-up included clinical examination and renal US, performed at 3-monthly intervals during the first year and yearly thereafter. Patient age ranged from 32 to 68 years (mean age 52.4 years). 27(56.2%) of the patients were males and 21(43.8%) - females. 42(87.5%) of the cysts were peripheral, and 6(12.5%)-peripelvic; 28(58.3%) were localized to the left and 20 (41.7%) - to the right; and they ranged by size from 5 to 30 cm (mean 9.8 cm). 45 (93.8%) of the cysts were identified as category I, and only 3 (6.2%) - as category II, according to the Bosniak classification. None of the cases required conversion to open surgery. There were no peri- and postoperative complications. The average duration of the laparoscopic procedure was 55min, and the average perioperative blood loss - 50 mL. All patients had negative cytological and histological findings indicative for malignancy. The follow-up period ranged from 5 to 52ain months (average - 25.4 months). In 47cases (97.9%) exellent therapeutic results were reported: complete relief of clinical symptoms, fast recovery of physical activity and patient quality of life. There were three recurrences (6,2%) met in patients with multiple cysts, but only one of them required repeated surgery. Laparoscopic transperitoneal decortication is a miniinvasive, highly effective and safe method of treatment of symptomatic renal cysts. The immediate relief of clinical symptoms, the short period of reconvalescence, the excellent quality of life after surgery, and the low relapse rate confidently define it as the surgical method of choice.