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Retrograde Intrarenal Surgery for Symptomatic Renal Sinus Cysts: Long-Term Results and Literature Review

2018; Karger Publishers; Volume: 101; Issue: 2 Linguagem: Inglês

10.1159/000488685

1423-0399

Vito Mancini, Luigi Cormio, Nicola d’Altilia, Giuseppe Di Benedetto, P. Ferrarese, Matteo Balzarro, Lorenzo Defidio, Giuseppe Carrieri,

Renal cell carcinoma treatment

<b><i>Introduction:</i></b> To report the long-term multicenter experience with retrograde intrarenal holmium-laser incision (RIR-HoLI) in the management of symptomatic renal sinus cysts (RSCs). In the literature, RIR-HoLI has been shown to be a safe and effective treatment, but there are only a few reports regarding long-term results and reproducibility of this procedure. <b><i>Material and Methods:</i></b> From June 2010 to June 2015, 14 patients with symptomatic RSCs underwent RIR-HoLI. The mean age was 52.1 ± 11.28 years (range 28–77) and the mean cyst size was 53.2 ± 14.23 mm (range 35–90). In all cases, contrast-enhanced computer tomography (CT) showed compression of the renal pelvis by the cyst (no malignancy). Surgical outcome was assessed in terms of symptoms improvement (measured by Visual Analogue Scale [VAS] for pain) and renal ultrasound findings at 3–6–12 months postoperatively and then yearly. CT scan was carried out at 12 months follow-up. <b><i>Results:</i></b> RIR-HoLI was successful in all patients. The mean operative time was 47.8 ± 13.54 min (range 30–80) and mean hospital stay was 3.5 days (range 2–5). There were 2 Clavien grade II complications (flank pain and urgency delaying discharge). After surgery, all patients ­became asymptomatic (VAS score change, <i>p</i> = 0.0001). One patient had persistence of a small cyst (10 mm). Mean follow-up is 44 ± 17.24 months (range 24–84); all patients remained asymptomatic, with no signs of recurrence. <b><i>Conclusions:</i></b> RIR-HoLI proved to be a safe and effective treatment for symptomatic RSCs. In our experience, it provided excellent long-term results and was reproducible at 4 different ­institutions.