Percutaneous sclerotization of simple renal cysts with 95% ethanol followed by 24-48 h drainage with nephrostomy tube

Aim of the Study: We propose some technique devices for treating simple ren al cysts with percutaneous puncture (PCN) to reduce recurrences. Materials and Methods: Between January 1995 and December 1998, a series of 42 patient s, 13 females and 29 males, ranging in age between 49 and 73 were treated f or symptomatic kidney cystic disease. The cysts varied between 7.4 and 13.6 cm in diameter and from 100 to 570 cm(3) in volume. This technique consist s of echo-guided emptying of the cyst, and slowly inserting a quantity of p ure 95% ethanol, equivalent to about 1/3 of the cyst volume, into the cavit y. This acts as a sclerosant agent on the cyst walls. The protocol of this technique also includes positioning a curled drainage catheter, for 24-48 h , in suction, to ensure a correct collapse of the cyst walls and to avoid c yst recurrence. Results: Of the 42 patients treated, only 4 did not complet e the protocol. In 3 cases, the patients were not able to stand the procedu re because of intense pain during cyst filling with alcohol. The other pati ent had intracystic hemorrhage. The results were evaluated by ultrasonograp hy at 7 days post-operatively and then at 1, 3, 6, 9 and 12 months later. T here was a further follow-up lasting from 12 to 36 months. Of 38 patients t reated, 29 (76%) did not have any recurrence. 8 patients (21%) developed a small liquid layer of 3-4 cm, which did not enlarge in subsequent check-ups . We observed a recurrence, which spontaneously reduced in volume, only in 1 patient. Conclusions: This procedure was simple to apply in an out-patien t setting and used low-cost materials which are easily obtained. Moreover, the results appear to confirm the validity of this technique. Copyright (C) 2001 S. Karger AG, Basel.