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Laparoscopic decortication of symptomatic simple renal cysts: 10‐year experience from one institution
Author(s) -
SHIRAISHI KOJI,
EGUCHI SATOSHI,
MOHRI JUN,
KAMIRYO YORIAKI
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06249.x
Subject(s) - decortication , medicine , simple (philosophy) , laparoscopy , surgery , general surgery , philosophy , epistemology
In this Japanese retrospective study, laparoscopic decortication was performed in 36 patients. The authors suggest that this is a safe procedure with satisfactory long‐term symptomatic results. They also found that the procedure was still challenging for peripelvic cysts. OBJECTIVE To assess the long‐term results by symptomatic and radiological outcome of laparoscopic decortication of renal cyst, first reported in 1992. PATIENTS AND METHODS We retrospectively reviewed the records of 36 patients who had a total of 36 laparoscopic decortications at our institution between December 1993 and March 2004. Of these cysts, 30 were peripheral and six were peripelvic cysts; the patients were asked if they had pain or not. Changes of cyst size after decortication were determined by computed tomography and the serial changes of each cyst were evaluated as the percentage of the diameter before surgery. The relationships between radiological and symptomatic outcome or cyst location were examined. RESULTS Peri‐operative morbidity was satisfactory; with a mean (range) follow‐up of 67.2 (13–128) months the symptomatic and radiological success rates were 92% (33 of 36) and 81% (25 of 36), respectively. Peripelvic cysts were significantly correlated with radiological failure. Symptomatic improvement was evident by 3 months, while radiological improvement continued for up to 3–4 years after surgery. Seven asymptomatic patients with radiological failure selected a conservative follow‐up. CONCLUSIONS Laparoscopic decortication is safe and provides long‐term satisfactory symptomatic results. The radiological improvement was slower than the symptomatic improvement and several cysts remained large, indicating some reduction in volume that was enough to improve the symptoms. This procedure is still challenging for peripelvic cysts in terms of radiological results, yet feasible for the clinical outcome.