A Clinical Control Study on the Retroperitoneal Laparoscopy for Unilateral Simple Renal Cyst Decortication in Day Surgery Mode

Abstract Background: Under the constraints of the increasingly tight medical environment and cost, day surgery mode has become a favorable trend and attracts attention from clinicians. Currently, there are no standards or procedures on the retroperitoneal laparoscopy for unilateral simple renal cyst decortication in day surgery mode. We attempted to investigate the feasibility and safety criteria of unilateral simple renal cyst decortication by retroperitoneal laparoscopy in the day surgery ward and to compare the advantages and the disadvantages with conventional inpatient ward mode.Methods: A total of 41 patients with unilateral simple renal cysts meeting surgical indications were enrolled in this study. To see whether patients in the day group could successfully complete the procedure and be admitted and discharged within 24 hours and to summarize the advantages and the advantages. The indexes of the operation time, time of hospitalization, postoperative complication rate, total costs of hospitalization and other indicators were compared between the two groups.Results: 41 cases of unilateral simple renal cyst decortication were completed successfully. Patients were followed up 10-12 months after surgery. The results of time of hospitalization, total costs of hospitalization and time of postoperative removal of drainage tube were statistically significant between the two groups of the day ward group and the inpatient ward group (P <0.05). Conclusions: We concluded the retroperitoneal laparoscopy for unilateral simple renal cyst decortication in patients with unilateral renal cysts was safe and feasible in day surgery mode under certain indicative criteria. The criteria included patients’ age between 40 and 80 years, no previous history of abdominal surgery, CT showing a unilateral renal cyst (Bosniak I or II), preoperative ASA assessment was I or II, no contraindications to surgery or anesthesia, postoperative team management and discharge assessment. Advantage of reducing time of hospitalization and total medical cost may relieve the situation of the shortage of medical resources.

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A Clinical Control Study on the Retroperitoneal Laparoscopy for Unilateral Simple Renal Cyst Decortication in the Day Ward

10.21203/rs.3.rs-26011/v1 ◽

2020 ◽

Author(s):

Xiao-Liang Zhu ◽

Yasmeen Bano ◽

song-jiang wu ◽

Hai-Hong Jiang

Keyword(s):

Renal Cyst ◽

Previous History ◽

Operation Time ◽

Renal Cysts ◽

Development Trend ◽

Simple Renal Cyst ◽

Inpatient Ward ◽

Advantages And Disadvantages ◽

Hospitalization Costs ◽

Retroperitoneal Laparoscopy

Abstract BackgroundUnder the constraints of the increasingly tight medical environment and market economy, day surgery has a good development trend and attracts more and more attention from clinicians. To investigate the feasibility and safety of unilateral simple renal cyst decortication by retroperitoneal laparoscopy in the day ward and to compare the advantages and disadvantages of conventional inpatient ward.MethodsA total of 41 patients with unilateral simple renal cysts meeting surgical indications were included in this study. The patients were divided into the day ward group and inpatient ward group by the patients' wishes. The indexes of operation time, time of hospitalization, intraoperative blood loss, time of postoperative extubation, postoperative complication rate, patients’ satisfaction rate, quality of life scores and total costs of hospitalization were compared between the two groups.Results41 cases of unilateral simple renal cyst decortication were completed successfully. Patients were followed up 10–12 months after surgery. CT or b-ultrasound examination indicated that the original renal cyst had been decorticated surgically and no recurrence of the cyst was observed after 10 months of postoperative follow-up. Time of postoperative extubation were (9.7 ± 1.8) hours and (20.8 ± 5.5) hours, total hospitalization costs were (5790 ± 99.8) RMB and (7496 ± 120.6) RMB, time of hospitalization were (22.7 ± 1.4) hours and (46.4 ± 11.3) hours in the day ward group and the inpatient ward group, respectively. In the above three aspects, the differences between the two groups were statistically significant (P < 0.05).ConclusionIn this study, we concluded that the retroperitoneal laparoscopy for unilateral simple renal cyst decortication in patients aged between 48 and 80 years, with no previous history of abdominal surgery, unilateral renal cysts (Bosniak grades I or II) on CT, ASA grades I or II, and no surgical or anesthetic contraindications, was safe and feasible in the day ward. Its obvious advantages of reducing time of hospitalization and total costs of hospitalization were worthy of clinical promotion.

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Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

African Journal of Urology ◽

10.1186/s12301-021-00203-4 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Mahmoudreza Kalantari ◽

Shakiba Kalantari ◽

Mahdi Mottaghi ◽

Atena Aghaee ◽

Salman Soltani ◽

...

Keyword(s):

Renal Cyst ◽

Left Kidney ◽

Previous History ◽

Mucinous Cystadenoma ◽

Single Layer ◽

Renal Cysts ◽

Cystic Mass ◽

Flank Pain ◽

History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

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EFFECT OF OPERATING TIME OF THE WELLS IN THE STEADY DRAINAGE MODE BEFORE STOPPING ON THE RESULTS OF THE STUDY OF PRESSURE BUILD-UP CURVES

Oil and Gas Studies ◽

10.31660/0445-0108-2017-1-48-50 ◽

2017 ◽

pp. 48-50

Author(s):

E. F. Gilfanov

Keyword(s):

Operating Time ◽

Previous History ◽

Operation Time ◽

Pressure Recovery ◽

Recovery Curve ◽

History Of ◽

Accuracy Of Results ◽

Theoretical Pressure

Operation time of the well before stopping for investigating the pressure recovery curve in hydrodynamic studies is an important parameter affecting the quality and accuracy of results of research processing. Comparing the actual and theoretical pressure curves and the derivative, it’s possible to eliminate the uncertainty in the choice of previous history of the well operation.

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P0225THE PRESENCE OF SIMPLE RENAL CYST IS ASSOCIATED WITH INCREASED RISK OF ALBUMINURIA IN YOUNG ADULTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0225 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Hyo Jin Boo ◽

SEUNGMIN SONG ◽

Jung Eun Lee ◽

Hye Ryoun Jang ◽

Wooseong Huh ◽

...

Keyword(s):

Young Adults ◽

Renal Cyst ◽

Renal Cysts ◽

Simple Renal Cyst ◽

Medullary Sponge Kidney ◽

Simple Cyst ◽

Cross Sectional ◽

Medical Checkup ◽

Single Cyst ◽

Increased Risk

Abstract Background and Aims It is well-known that the prevalence of simple renal cyst increases with age. However, simple cysts are occasionally found in adults younger than 40 years of age. This cross-sectional study evaluated the clinical significance of simple renal cysts in young adults, focusing on the associations with hematuria and albuminuria. Method Adults younger than 40 years who received a comprehensive medical checkup from January 2005 to December 2013 were included. Simple renal cysts were identified by ultrasonography. Results Among 5832 subjects, renal cysts were found in 276 (4.7%). Subjects diagnosed with polycystic kidney disease (n=5) or medullary sponge kidney (n=1) were excluded from the analyses. A single cyst and multiple cysts were found in 234 (4.0%) and 42 (0.7%) subjects, respectively. The locations of single cyst were cortex in 187, medulla in 26, and parapelvic region in 21. Age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.02-1.12 per 1-year increment, P = 0.002), systolic BP (OR, 1.01; 95% CI, 1.00-1.02 per 1-mmHg increment, P = 0.006), and hypertension (OR, 1.85; 95% CI, 1.24-2.76, P = 0.003) were independent predictors of the presence of simple cyst. The presence of cysts was not associated with increased prevalence of hematuria. While, the subjects with cysts had higher prevalence of albuminuria than those without cysts (11.3% vs. 4.5%, P <0.001). Multivariate analyses of albuminuria revealed that the presence of simple renal cyst was associated with a 2.30-fold increase in the prevalence of albuminuria (95% CI 1.512-3.519, P <0.001) independently of other risk factors. The location of the cysts was not related to the prevalence of albuminuria. Conclusion The presence of simple renal cysts was independently associated with increased prevalence of albuminuria. The causal relationship between renal cysts and albuminuria needs to be elucidated in further studies.

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Iatrogenic ureteral injury during retroperitoneal laparoscopy for large renal cysts: What we learned and a review of the literature

Journal of X-Ray Science and Technology ◽

10.3233/xst-200804 ◽

2021 ◽

Vol 29 (1) ◽

pp. 185-196

Author(s):

Zejian Zhang ◽

Dong Chen ◽

Ling Deng ◽

Wei Li ◽

Xisheng Wang ◽

...

Keyword(s):

Renal Cyst ◽

Large Diameter ◽

Renal Cysts ◽

Ureteral Injury ◽

Ureteral Stent ◽

Lumbar Region ◽

Retroperitoneal Laparoscopy ◽

Iatrogenic Ureteral Injury

PURPOSE: To avoid Iatrogenic ureteral injury during retroperitoneal laparoscopy for large renal cyst (diameter > 70 mm), we present two cases of iatrogenic ureteral injury and discuss their clinical courses and final outcomes. PATIENTS AND METHODS: Two male patients (47 years old and 74 years old) with large left simple renal cysts underwent a retroperitoneal laparoscopic operation to treat the cysts. In the first patient, the left proximal ureter was partially transected (Grade 3) during the operation. The injury was identified intraoperatively. The transection was managed with a primary ureteroureterostomy (end to end) along with a double J ureteral stent. In the second patient, the left proximalureter was partially transected (Grade 4). However, the injury was unrecognized postoperatively for two days. After recognition of the complication, the injury was managed with an early primary ureteroureterostomy, which followed a failed attempt to place ureteral stent endoscopically. RESULTS: In the first patient, a postoperative urinary leakage developed and lasted for 13 days. During long term follow-up of the first patient after the urine leak resolved, there were no reports of pain in the lumbar region or other discomfort. No recurrence of the renal cyst occurred, which was confirmed with an ultrasound at one year postoperatively. In the second patient a ureteral fistula and severe perirenal infection occurred and lasted for 86 days. The patient ultimately underwent a left nephrectomy after conservative management for this surgical complication failed. This patient developed a chronic wound infection that lasted for 3.14 months following the nephrectomy. During follow-up post nephrectomy, the patient developed stage 3B moderate chronic kidney disease (CKD) (GFR = 30 –44 ml/min). CONCLUSIONS: For single large (diameter > 70 mm) renal cysts located at the lower pole of the kidney, it is recommended to not completely dissect out and mobilize the entire renal cyst for cyst decortication in order to avoid injuring the ureter. Iatrogenic ureteral injury increases the risk of readmission and serious life-threatening complications. The immediate diagnosis and proper management ureteric injury can reduce complications and long term sequalae.

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Renal calyceal diverticulum mimicking a large renal cyst-A case report

Biomedicine ◽

10.51248/.v40i3.44 ◽

2020 ◽

Vol 40 (3) ◽

pp. 409-411

Author(s):

Ravirajendran Samson ◽

Ramasamy Neelakandan ◽

Thirunavukkarasu Chandru ◽

Kumaresan Natarajan

Keyword(s):

Case Report ◽

Renal Cyst ◽

Transitional Cell ◽

Renal Cysts ◽

Retrograde Pyelogram ◽

Calyceal Diverticulum ◽

Ct Urogram ◽

History Of ◽

Loin Pain ◽

Ct Finding

Renal calyceal diverticulum are outpouching from renal calyx or pelvis into the renal cortex lined by transitional cell epithelium. We report a case of 35 years old male with history of accidental fall from bike, who presented with persistent right loin pain and hematuria. CT Urogram showed multiple large right renal cysts (BOSNIAK II). Patient was planned laparoscopic renal cyst deroofing. Due to suspicion of calyceal diverticulum, an intraoperative Retrograde Pyelogram (RGP) was done which showed calyceal diverticulum. Laparoscopic calyceal diverticulotomy with closure of communication was done. If only a cyst deroofing was done considering the CT finding alone, it would have ended up in post-operative complication of urinoma which may require a re-surgery. This case report emphasizes the importance of anticipating calyceal diverticulum and intraoperative attempts in the form of doing RGP to identify calyceal diverticulum which mimic renal cyst regardless of CT finding in suspected cases. Keywords: Calyceal diverticulum; large renal cyst; retrograde pyelogram; laparoscopic calyceal; Diverticulotomy.

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Femoral Nerve Injury as a Complication of Percutaneous Simple Renal Cyst Sclerotherapy with Ethanol: A Case Report

Case Reports in Medicine ◽

10.1155/2012/589108 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Alireza Ashraf ◽

Mohammad Yasin Karami ◽

Aida Amanat

Keyword(s):

Nerve Injury ◽

Renal Cyst ◽

Alcohol Intoxication ◽

Femoral Nerve ◽

Rare Event ◽

Renal Cysts ◽

Simple Renal Cyst ◽

Percutaneous Injection ◽

Ethanol Sclerotherapy ◽

Femoral Nerve Injury

Simple renal cysts are benign, common, and often asymptomatic disease in old age, sometimes treated with ethanol sclerotherapy. We report a case of iatrogenic femoral nerve injury following percutaneous injection of ethanol into a renal cyst under sedation. The percutaneous injection was guided by sonography. At the end of the procedure, the cyst ruptured so the patient progressed to loss of consciousness due to alcohol intoxication. Ethanol was damaged to the femoral nerve, so patient was developed with limping, numbness, and weakness in anteromedial aspect of the right thigh. To the best of our knowledge, this is the first report of femoral nerve injury caused by percutaneous simple renal cyst sclerotherapy with ethanol. This rare event has not been previously described, Physicians should be aware of the possibility of this complication.

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A New Technique for Simple Renal Cyst: Cystoretroperitoneal Shunt

Advances in Urology ◽

10.1155/2009/906013 ◽

2009 ◽

Vol 2009 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Onder Canguven ◽

Cemal Goktas ◽

Faruk Yencilek ◽

Cihangir Cetinel ◽

Selami Albayrak

Keyword(s):

Renal Cyst ◽

Renal Cysts ◽

Simple Renal Cyst ◽

Ultrasound Guided ◽

Cyst Volume ◽

Mean Size ◽

The Mean ◽

A New Technique ◽

A Prospective Study

Purpose. To evaluate the results of patient symptoms and radiologic outcomes of cystoretroperitoneal shunt (CRS) technique in the treatment of symptomatic simple renal cysts.Patients and Methods. In a prospective study, 37 patients with a simple renal cyst were treated with ultrasound-guided percutaneous CRS-catheter. Radiological success was indicated as no recurrence of the cyst or a reduction in cyst volume by at least half.Results. CRS technique was performed successfully in 36 patients with a simple renal cyst. The mean size of all cysts decreased from 8.8 cm (range 7 to 14) to 1.7 cm (range 0 to 9; ). Symptomatic success (pain relief) was achieved in 29/36 (80.5%) of patients, and radiographic success was achieved in 23/36 (63.8%) of patients, with a median follow-up of 16 months (range 6 to 24).Conclusion. Ultrasound-guided percutaneous CRS technique for simple renal cysts is fast, safe, effective, and inexpensive.

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Endothelin-1 Level in Patients with Simple Renal Cyst

Folia Medica ◽

10.3897/folmed.61.e47954 ◽

2019 ◽

Vol 61 (4) ◽

pp. 545-550 ◽

Cited By ~ 1

Author(s):

Selahattin Çalişkan ◽

Mustafa Sungur ◽

Bariş Eser ◽

Mustafa Kanbay ◽

Hüseyin Kocan ◽

...

Keyword(s):

Blood Pressure ◽

Kidney Disease ◽

Renal Cyst ◽

Renal Cysts ◽

Systemic Hypertension ◽

Simple Renal Cyst ◽

Endothelin 1 ◽

Significant Difference ◽

Group 2 ◽

Group 1

Introduction: Endothelin-1 (ET-1) is potent vasoconstrictive peptide and elevated ET-1 levels are associated with hypertension, endothelial dysfunction and atherosclerosis. Research on (ET-1) has demonstrated that elevated ET-1 levels in autosomal dominant polycystic kidney disease leads to systemic hypertension. The prevalence of simple renal cysts increases with age and the association with simple renal cyst and hypertension is not clear. The aim of this study was to investigate the ET-1 levels in patients with simple renal cyst and compare them with those in healthy adults. Materials and methods: The study included patients that underwent laparoscopic renal cyst decortication in the Department of Urology and healthy controls. Serum and urinary ET-1 levels were measured before surgery and one month after it in the patients with simple renal cyst. Serum ET-1 levels were measured in healthy adult patients. Ambulatory blood pressure was measured in all patients. Glomerular filtration rate was measured according to the chronic kidney disease epidemiology collaboration formula. Results: Thirty-two patients were included in the present study. Of these, 16 patients with simple renal cyst were allocated into group 1 and 16 healthy patients - in group 2. There was no significant difference between systolic and diastolic blood pressure between the groups (p=0.820 and p=0.618, respectively). Serum EL-1 levels were significantly lower in group 1 than those in group 2 (p=0.036). Interestingly, serum EL-1 levels were increased after laparoscopic cyst decortication and there was no significant difference with healthy patients (p=0.429). Conclusions: The present study demonstrated that serum EL-1 level in patients with simple renal cyst was lower than that in healthy people. Further studies are needed to investigate the EL-1 levels in simple renal cyst patients.

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Infected simple renal cyst due to Streptococcus pneumoniae rapidly diagnosed by the melting temperature mapping method: a case report

BMC Pediatrics ◽

10.1186/s12887-021-02736-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yoji Uejima ◽

Hideki Niimi ◽

Reiko Kato ◽

Mihoko Furuichi ◽

Satoshi Sato ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

Pleural Effusion ◽

Melting Temperature ◽

Antimicrobial Stewardship ◽

Renal Cyst ◽

Renal Cysts ◽

Mapping Method ◽

Rrna Gene ◽

Antibiotic Administration ◽

Simple Renal Cyst

Abstract Background Spontaneous infection of preexisting solitary renal cysts has been documented in adults but is extremely rare in children. To date, no cases of simple renal cysts infected with Streptococcus pneumoniae have been described. Recently, reports have described the diagnosis of bacterial infection using the 16 S rRNA gene as well as the accompanying antimicrobial stewardship for microorganisms that are difficult to culture and for culture-negative cases after preceding antibacterial administration. Case presentation A four-year-old Japanese girl who had a pleuroperitoneal shunt inserted to drain a right pleural effusion due to occlusion of the hepatic portion of the inferior vena cava at three years old visited our hospital due to fever and respiratory discomfort. She was incidentally found to have a right simple renal cyst 10 months before admission. The patient was suspected to have pneumonitis or catheter-related blood stream infection on chest X-ray, which showed right-side pleural effusion. She was diagnosed with invasive pneumococcal infection, as Streptococcus pneumoniae was detected from blood culture on admission. Transient improvements in her symptoms and decreases in the white blood cell count and C-reactive protein level were observed after effective antibiotic administration, but her respiratory condition deteriorated. Enhanced CT showed right renal cyst enlargement and enhancement and thickening of the surrounding wall. Using the melting temperature (Tm) mapping method, S. pneumoniae was rapidly detected directly from pus 4.5 hours after drainage. The specimen culture was negative, but the extracted 16 S rDNA sequence revealed 100 % identity for S. pneumoniae from the same specimen the subsequent day. We successfully performed optimal treatment and reduced medical cost based on the positive Tm mapping method result. Conclusions We report the first case of a S. pneumoniae-infected simple renal cyst. The drainage culture was negative, but the Tm mapping method rapidly detected S. pneumoniae directly from the drainage. The Tm mapping method may have great impacts on rapid diagnosis and effective antimicrobial stewardship.

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