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BACKGROUND: On occasion, patients can develop flank pain from large simple cysts or from multiple cysts associated with ADPKD. We report our experience with laparoscopic renal cyst decortication for symptomatic renal cysts to determine safety and efficacy.
METHODS: A retrospective analysis was performed including all laparoscopic renal cyst decortications performed by a single surgeon at our institution over a 6 year period. Demographic data as well as information including surgical indication, cyst size, operative times, EBL, LOS, complications, interval to follow up and outcomes were reviewed.
RESULTS: A total of 26 procedures were performed (21 patients). At least 2 patients had previously failed percutaneous aspiration with reaccumulation of cystic fluid. Average OR time was approximately 135 minutes with reported EBL of 200 cc or less for all cases. Nineteen of 26 patients were discharged home within 24 hours postop with no immediate post operative complications reported other than a single episode of urinary retention. All but 2 patients reported either full resolution or dramatic improvement of their preoperative symptoms. Interestingly, 5 patients with ADPKD or large bilateral renal cysts underwent staged bilateral cyst decortication after treatment of the more symptomatic side unmasked worsened contralateral flank pain. Overall efficacy of laparoscopic renal cyst decortication was 92.5% (24 of 26 patients).
CONCLUSION: Laparoscopic renal cyst decortication is a safe and effective procedure to improve pain associated with large cysts or multiple renal cysts associated with ADPKD. In our series, nearly all patients report full resolution of symptoms with no major operative complications.