Comparison of the results and complications Laparoscopic removal of renal cysts with percutaneous drainage and sclerosing injections

Abstract

Simple renal cysts are very common in adults and their incidence increases with age. They are usually diagnosed incidentally on an ultrasound, CT scan, or urography performed for urinary tract or other abdominal problems. Clinically, renal cysts are usually categorized as simple or complex. Simple cysts have a low risk of malignancy, while complex cysts are likely to be symptomatic and can lead to various complications, such as back pain, urinary tract infection, bleeding, hematuria, hypertension, and a higher likelihood of malignancy. Treatment options for symptomatic cysts include aspiration, aspiration with injection of sclerosing agents, cyst excision, and laparoscopy. Each of these methods has its advantages and disadvantages. According to the reviews, there are no clear indications for choosing a specific treatment method or technique. Therefore, in this study, we decided to compare the results and side effects of two treatment methods: laparoscopic renal cyst surgery and cyst drainage through the skin with sclerosing agent injection. Methods: In this study, 80 patients with renal cysts who were referred to Imam Reza (AS) Tabriz Hospital from June 2023 to March 2023 were included in the study, and divided into two groups, each consisting of 40 individuals: one group underwent cyst drainage through percutaneous and sclerosing agent injection (PCN), while the other group recieved laparoscopic surgery treatment. The patients were evaluated and statistically analyzed in terms of the average duration of the intervention, the duration of hospitalization, pain, the cost of both methods, the rate of complications after the intervention, and the average recurrence of cysts in both methods after 3 months and 6 months. Results: The results of our study showed that the cyst drainage group through percutaneous methods had a shorter operating time and hospitalization, as well as a lower surgical cost compared to the laparoscopic group. The incidence of complications such as infection, bleeding, and fever was lower in both groups, and there was no significant difference in terms of pain. Additionally, the rate of cyst recurrence in the patients of cyst drainage group through percutaneous methods (41.2%) was higher than that of the laparoscopic group (21.6 %) and there was a significant difference (p=0.01), (p=0.003), (p=0.04).