Téma: 

Laparoscopic decortication of renal cysts

Ján Ľupták, Michael Vraný, Ján Švihra, Boris Eliáš, Ján Kliment jr., Roman Tomaškin

Objective: Transperitoneal and retroperitoneal laparoscopic decortication of renal cysts is an alternative therapeutic method to open surgery. The aim of the study is to evaluate the results of laparoscopic operations of renal cysts. Material and methods: Authors present the retrospective analysis of 18 patients at the age of 38 - 67 yrs (median 52.6 yrs) who were operated at our department within the period of 2004 - 2007. The patients underwent laparoscopic decortication of renal cysts. Ureteral catheter was placed in the renal pelvis before the operation to verify communication of a cyst with the collecting system of the kidney. Surgical procedure was performed in lumbotomic position and 3 or 4 ports (2 x 10 mm and l - 2 x 5 mm) were used. Ports localization depends on using approach (in transperitoneal approach under the ribs arch, and in retroperitoneal approach between anterior and posterior axilar line and between superior margin of 12th rib and crista iliaca.) Results: Four patients (22.2 %) out of 18 were operated via transperitoneal approach and 14 (77.8 %) patients were operated via retroperitoneal approach. Two patients (11.2 %) operated via transperitoneal approach underwent homolateral adrenalectomy at the same time. Cyst relapse was found out in two patients (11.2 %) after unsuccessful cyst sclerotization at other hospital. Operating time was 48 - 163 min (median 94 min) and size of removed cyst was 45 - 93 mm (median 78.3 mm). Lower pole localization of the cyst was in 5 patients (27.8 %), upper pole cyst was in 5 patients (27.8 %) and middle part cyst in 8 patients (44.4 %). More severe complication (urinoma with sepsis) was detected in one patient (5.5 %). Average time of hospitalization was 4.4 days (2 - 21 days), in last 7 patients 3.1 days (1 - 4 days). Conclusion: Laparoscopic decortication of renal cysts is the modern treatment option with low morbidity, high therapeutic success, short time of hospitalization and early return to the working process.

Ročník 2007  Témy časopisu Clinical urology 2 / 2007

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