Transperitoneal Laparoscopic Management Of Parapelvic Renal Cysts: Nine Cases

Background:Parapelvic renal cyst is one special and rare type of renal cystic disease.In general it cause no obvious symptoms.But oppression of renal collecting system or renal vascular can cause waist soreness,low back pain,microscopic hematuria, hydronephrosis,hypertension and other clinical symptoms.It is mainly rely on the intravenous pyelography,color ultrasound,CT and other imaging examinations to make the diagnoses.And it's particular for treatment,because parapelvic renal cyst is so close to the pelvis and the renal vessels.Traditional methods of open unroofing lead to larger body injuries,directly or indirectly affecting the environment in vivo,slower postoperative recovery,and easily causing the near term,or long-term complications, However,B ultrasound guided cyst puncturing also can increase the risk of possibility of pleural and renal vascular injuries.And it and higher risk of recurrence.With the development of urology,traditional methods mentioned above have been used less.In recent years,the practice to observe the effect of transperitoneal laparoscopic unroofing for the management of parapelvic renal cysts medicine has been made by doctors across the country,and it has been reported to make good results in the literature.At present,however,most of Chinese urologists prefer retroperitoneoscopic unroofing of parapelvic renal cysts,and there are much less reports about transperitoneal laparoscopic management of parapelvic renal cysts.Methods1.Parapelvic renal cyst definitionCyst originated in the renal sinus is named peripelvic renal cyst,while cyst originated outside the renal sinus,and invasive to renal sinus is named peripelvic renal cyst.Clinically,these two types above are generally known as the Parapelvic renal cyst.2.Case collectionCollected from February 2008 to February 2009,a total of 9 cases done by transperitoneal laparoscopic management of parapelvic renal cysts.Results:All of the cases were successfully operated.Operation time was 30min(range 20-40min).Intraoperative bleeding was 25ml(range 20-30ml).All of the cases started intake and activity in the next day after operation.The time to removal of postoperative peritoneal cavity drainage tube was 24-48 hours.The amout of drainage was 16ml per day(range 10-20ml per day).All patients discharged in the second or the third day after the surgery.There were no recurrence in the following 1-11months' postoperative follow-up.Conclusion:Transperitoneal laparoscopic unroofing is a Simpler operation,faster postoperative recovery and lower risk of recurrence.Transperitoneal laparoscopic management is a safe and feasible alternative for the management of parapelvic renal cysts.