LAPAROSCOPIC MARSUPIALIZATION OF THE PAINFUL POLYCYSTIC KIDNEY

Autosomal dominant polycystic kidney disease patients may present with intractable cyst pain. Common practice has been to attempt percutaneo us drainage of the affected cyst and, if unsuccessful, to offer open s urgical decortication. We report laparoscopic renal cyst marsupializat ion for painful autosomal dominant polycystic kidney disease among 6 p atients who failed prior percutaneous drainage. Mean surgical and anes thesia times were 3 hours and 3 hours 35 minutes, respectively. Mean b lood loss was 140 cc. Median intervals to ambulation, oral intake and hospital discharge were 1.5, 1.5 and 3 days, respectively. All 6 patie nts reported pain relief with followup of 6 to 40 months. These result s suggest that laparoscopic marsupialization of painful autosomal domi nant polycystic kidney disease is technically feasible and safe, and t he laparoscopic approach may offer a palliative option for patients in whom prior percutaneous management failed.