Laparoscopic ablation of symptomatic parenchymal and peripelvic renal cysts

Objectives. To assess the safety and efficacy of laparoscopic ablation of s ymptomatic renal cysts as minimally invasive therapeutic techniques have la rgely supplanted open surgical intervention for the treatment of symptomati c renal cysts. Methods. The records of 32 consecutive adult patients who underwent laparos copic ablation of renal cysts (11 peripelvic, 21 parenchymal) were retrospe ctively reviewed. All patients were symptomatic at presentation; 26 had a s ingle cyst, 5 had two cysts, and 1 had four cysts. Results. Twenty patients underwent a transperitoneal laparoscopic approach, and 12 patients underwent a retroperitoneal laparoscopic approach. An aver age of 3.2 ports were used for each procedure, and no open conversions or t ransfusions were necessary. When comparing patients with parenchymal and pe ripelvic cysts, statistically significant differences were noted in the mea n operative time (164 versus 233 minutes, respectively; P = 0.003) and mean operative blood loss (98 versus 182 mL, respectively; P = 0.04). Four pati ents (13%) had complications (one major and three minor), including a persi stent ureteral stricture. One patient with negative preoperative aspiration cytology and negative intraoperative frozen section analysis was later fou nd to have malignancy within the cyst wall, necessitating radical nephrecto my and trocar site excision. One patient (3%) developed a recurrence. Conclusions. Laparoscopic ablation of symptomatic renal cysts is a safe and efficacious procedure. We report an overall complication rate of 13% and a recurrence rate of 3% with a mean follow-up of 18.1 months (median 10.0). UROLOGY 58: 165-169, 2001. (C) 2001, Elsevier Science Inc.