Herein we report on the results of 171 out of 214 patients with renal
cysts. In 127 cases diameter of
cyst being less than < 6 cm, was monitored repeating renal ultrasound every 6 months: 78 patients underwent pecutaneous
cyst echoguided
puncture, while 9 patients were treated as follows: 4 by open surgery, 3 by laparoscopy and 2 by percutaneous treatment in general anaesthesia.
Cysts are classified in 4 types and
therapy is different according to Bosniak's classification. When the
cyst is less than 6 cm in diameter and symptomatology is absent, we follow the patients up with yearly ultrasound. In our experience
cyst sclerotization is carried out by injecting either
ethanol or
Trombovar or 50%
glucose in water alone or associated with 2%
Aethoxysclerol. The best results are obtained from the use of
ethanol (30% of the volume of
cyst). However some relapses are encountered after this kind of procedure. In these cases it is helpful to examine the cystic wall because of the presence of intracystic septa. Percutaneous treatment by means nephroscopy permits to visualize the cystic wall but it is not able to perform a biopsy of its wall. Laparoscopic treatment is performed by inserting 5
trocars with the patient under general anaesthesia. This technique is able to localize and biopsy the cystic wall without causing side-effects or complications. Open surgery was performed only in 4 patients affected with hidatid
cyst. At present echoguided
cyst puncture permits to approach the renal not complicated
cysts, while laparoscopy constitutes a safe treatment in the case of benign recurrent and complicated
cysts.(ABSTRACT TRUNCATED AT 250 WORDS)