Percutaneous intrarenal marsupialization of symptomatic peripelvic renal cysts: A single-centre experience in China

Abstract

Objective.The aim of this study was to report the authors' experience with percutaneous intrarenal marsupialization of symptomatic peripelvic renal cysts. Material and methods. Thirty-one patients (16 male and 15 female, with a mean age of 49 years) with a peripelvic renal cyst associated with chronic flank or lumbar pain or urinary infection were selected for percutaneous intrarenal marsupialization with a 2 μm laser in the authors' centre from January 2005 to December 2010. Cyst size ranged from 4.5 to 10.5 (mean 6.0) cm. The cysts were punctured by a percutaneous technique guided by ultrasonography, a 20.8 F nephroscope was introduced and the whole internal surface of the cyst was inspected. Methylene blue was injected through the ureteral catheter to help identify the collecting system. A 1.5–4 cm incision was made at the avascular area of the cystic wall by the 2 μm laser to achieve intrarenal marsupialization of the cyst into the renal collecting system. One or two 6 F double-J stents were placed with the proximal end in the cyst for 2–3 months. Results.The mean operation time was 50 (25–120) min. No serious complications such as massive bleeding, urine leak or infected haematoma occurred. The patients were followed up for a mean of 12 (range 3–36) months. All patients were relieved of their symptoms. Eighteen cysts disappeared after surgery, while 13 cysts reduced in size by over one-third and communicated with the renal collecting system. No enlargement of cysts was observed. Conclusions.Percutaneous intrarenal marsupialization with a 2 μm laser is an effective and safe procedure and may offer a minimally invasive alternative for the management of symptomatic peripelvic renal cysts.

Key Words::

• cystic
• endoscopy
• kidney
• laser
• percutaneous technique

Declaration of interest: There are no conflicts of interest relevant to the study reported in this article.