Objectives: To report our single-center experience of retroperitoneoscopic renal cyst decortication in the treatment of symptomatic peripelvic renal cysts.
Methods: From January 2003 to July 2010, 36 patients with symptomatic peripelvic renal cysts, mean size 7.9 cm (range 5.8-12), underwent retroperitoneoscopic cyst decortication. The patients with complex renal cysts were excluded. Of the 36 patients, 2 had undergone an unsuccessful previous cyst aspiration. The Wong-Baker pain scale was used to assess the preoperative and postoperative pain scores. Radiologic success was defined as no recurrence on the most recent computed tomography scan.
Results: Retroperitoneoscopic renal cyst decortication was successful in all patients. No open conversions or transfusions were necessary. The mean operative time was 159 minutes (range 113-189), and the mean estimated blood loss was 55 mL (range 20-78). The mean hospital stay was 3.5 days. In 2 patients, the collecting system was entered, and a double-J stent, which drained the pelvis for 4 weeks, was placed at the end of the procedure. No evidence of urine leakage was found postoperatively. Symptomatic success was achieved in 35 (97.2%) of the 36 patients, and imaging-proved success was achieved in 34 (94.4%). The mean follow-up period was 48 months (range 3-89).
Conclusions: Our results have confirmed that retroperitoneoscopic peripelvic renal cyst decortication is a safe, feasible, and effective procedure. It offers a favorable minimally invasive treatment option for symptomatic peripelvic renal cysts, although it remains technically challenging.
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