Semptomatik basit böbrek kistlerinin tedavisi: Kısa dönem ilk laparoskopik sonuçlarımız

Year 2011, Volume: 6 Issue: 3, 31 - 34, 01.08.2011

İlhan Geçit Mehmet Kaba Necip Pirinççi Mustafa Güneş Özcan Canbey Kadir Ceylan

Abstract

Amaç: Semptomatik basit böbrek kistlerinin laparoskopik yönetimi ile ilgili ilk sonuçlarımızı sunmak.Gereç ve Yöntem: Haziran 2010 ve Kasım 2010 tarihleri arasında semptomatik böbrek kisti olan 15 hastayı laparoskopik yöntemle tedavi ettik. Hastaların genel ve cerrahi bilgileri prospektif olarak kayıt edildi.Bulgular: Hastaların ortalama yaşları 59.6 ± 12.6 yıl, 7’si %47.7 bayan, 8’i %53.3 erkek idi. En sık semptom ağrıydı. Ortalama kist çapı 7.8 ± 2.2 cm olarak tespit edildi. Bütün hastalar transperitoneal yaklaşımla tedavi edildi. Kistlerin 11 tanesi sağ böbrekte, 4’ü ise sol böbrekteydi. Ayrıca 1 vakada her iki böbrekte kist mevcuttu. Ortalama hastanede kalış süresi 2.1 ± 0.3 gün olup, ortalama operasyon süresi 30.9 ± 5.7 dakika olarak gerçekleşti. Bütün kistler Bosniak tip1 olarak sınıflandırılmıştı. Bütün kistlerin patolojisi basit böbrek kisti olarak rapor edildi. Hiçbir olguda tekrarlama görülmedi.Sonuç: Semptomatik basit böbrek kistlerinin laparoskopik olarak tedavisi güvenli ve etkin, ayrıca tekrarlama ve morbidide oranı düşük başarılı bir yöntemdir

Keywords

Laparoskopi , Tedavi , Böbrek Kisti

Treatment of the symptomatic simple renal cysts: Our first short-term laparoscopic results

Abstract

Objective: Our aim is to present our first results about the laparoscopic management of the symptomatic simple renal cysts. Materials and Methods: We treated 15 patients who had the symptomatic renal cysts with the laparoscopic method between June 2010 and November 2010. General and surgical data of the patients were prospectively recorded. Results: The mean ages of the patients were 59.6 ± 12.6 , 7 of whom were female 47.7% and 8 of whom were males 53.3% . The most common symptom was pain. The mean cyst diameter was determined as 7.8 ± 2.2 cm. All of the patients were treated with the transperitoneal approach. 11 of the cysts were in the right kidney, and 4 of the cysts were in the left kidney. In addition, 1 patient had the cysts in both kidneys. The average duration of the hospital stay was 2.1 ± 0.3 days, and the mean duration of the operation was lasted for 30.9 ± 5.7 minutes. All of the cysts were classified as Bosniac type 1. All cases were pathologically reported as simple renal cyst. No recurrence was observed in the patients. Conculusion: The laparoscopic treatment of the symptomatic simple renal cysts is a safe, effective and successful method with lower recurrence and morbidity

References

• Siegel CL, McFarland EG, Bring JA, Fisher AJ, Humprey P, Heiken JP. CT of cystic renal masses:analysis of diagnos- tic performance and interobserver variation. Am J Roent- genol. 1997;169:813-818
• Amar, A. And Das, S. Surgical manegement of bening re- nal cysts causing obstruction of renal pelvis. Urology. 1984; 24: 429.
• Moufid K, Joual A, Debbagh A, el Morini M. Lumboscopic treatment of simple renal cysts:initial experience with 17 cases. Prog. Urol. 2002;12:1204-1208
• Zulluaga Gomez A, Arabbal martin M, de la Fuente Ser- rano A, Mijan Ortiz YL, Martinez Torres JL, Fernandez Rodriquez A. Laparoscopic treatment of the symtomatic renal cyst: the indications and bibliographic review. Arch. Esp. Urol. 1995;48: 282-289.
• Hulbert JC. Laparoskopic management of renal cystic dise- ase. Semin. Urol. 1992;10:239-41.
• Okke AA, Mitchelmore AE, Keeley FX, Timoney AG. A comparison of aspiration and sclerotherapy with laparos- copic de-roofing in the manegement of symtomatic simple renal cysts. BJU Int 2003;92:610-613.
• Glassberg KI. Renal dysplasia and cystic disease of the kid- ney. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds). Campbell’s Urology, 7th edn. W.B. Saunders, Philadelphia, PA, 1998;1764.
• Wolf J S Jr. Evaluation and management of solid and cystic renal masses. J Urol, 1998;159:1120.
• Hana RM, Dahniya MH. Aspiration and sclerotherapy of symptomatic simple renal cysts: value of two injections of a sclerosing agent. AJR Am. J. Roentgenol. 1996;167:781- 783.
• Demir E, Alan C, Kilciler M, Bedir S. Comparison of eta- nol and sodium tetradecyl sulfate in the sclerotherapy of renal cyst. J Endourol. 2007;21:903-905.
• Kilinc M, Tufan O, Guven S, Odev K, Gurbuz R. Percuta- neous injection sclerotherapy with tetracycline hydrochlo- ride in simple renal cysts. Int Urol Nephrol. 2008;40:609- 613.
• Madeb R, Feldman PA, Knopf J, Rub R, Erturk E, Yachia D. Povidone- iodine sclerotherapy is ineffective in the treat- ment of symptmatic renal cysts. J Endourol. 2006;20:402- 404.
• Su LM: Laparoskopic renal cyst ablation: Technique and results. In: Gill IS, ed. Texbook of laparoscopic urology. New York: Taylor&Francis Ltd; 2006;259-278.
• Abbaszadeh S, Taheri S, Nourbala MH. Laparoskopic de- cortication of symptomatic renal cysts: Experience from a referral center in Iran. Int J Urol 2008;15:486-489.
• Thwaini A, Shergill IS, Arya M, Budair Z. Long-term foow-up after retroperitoneal laparoscopic decortication of symptomatic renal cysts. Urol Int. 2007;79:352-355.
• Shiraishi K, Eguchi S, Mohri J, Kamiryo Y. Laparoscopic decortication of symptomatic simple renal cysts: 10- year experience from one institution. BJU Int. 2006;98:405-408.
• Atuğ F, Burgess SV, Ruiz-Deya G, Mendes-Torres F, Cas- tila EP, Thomas R. Long –term durability of laparosco- pic decortication of symptomatic renal cysts. Urology. 2006;68:272-275.