A Meta-analysis Of The Treatment In Renal Cysts And Effectiveness In Vivo Study Of Sclerotherapy After Applying Lauromacrogol On Rabbit Gallbladder Instead Of Renal Cysts

Objective：To evaluate the efficacy and safety of Sclerotherapy or Laparoscopicdecortication in the treatment of simple renal cysts. Pathologically studying sclerosingsolutions dealing with wall of gallbladder in vitro to select appropriate sclerotherapytime. To determine the therapeutic effect of different sclerosing solutions，we used therabbit gallbladder as renal cysts model sclerotherapy.Methods：Searched from CBM、CNKI、VIP、WangfangDate、Pubmed、MEDLINE. Selected1995-2013sclerotherapy or laparoscopic decortication treatmentof simple renal cysts randomized controlled trials(RCTs). Using the stata12.0softwareto conduct Meta-anal ysis.50%Glucose、Anhydrous ethanol and lauromacrogol wereselected as sclerosing solutions to treat wall of the rabbit gallbladder for5,10,15,and20minutes. The sclerosed wall of gallbladder was stained byhematoxylin-eosin(HE). Degeneration and necrosis of gallbladder were observed forselecting the appropriate time.27rabbits were randomly divided into5groups in vitro:The group A: physiological saline, perfusion gallbladder15minutes, as the controlgroup; the group B:50%glucose, perfusion gall bladder15minutes; the group C:anhydrous ethanol, perfusion gallbladder15minutes; the group D: lauromacrogol,perfusion gallbladder15minutes; the group E:lauromacrogol, reserved perfusion.Respectively breeding for1,3,5weeks. The sclerosed wall of gallbladder was stained byhematoxylin-eosin(HE).Observed the degeneration and necrosis degree of gallbladderby the microscopic,measured the thickness of the gallbladder wall and gallbladdervolume.Results：Eleven trials were included. There are5studies of detailed reports whichstated the postoperative recurrence of the situation. The meta-analysis showed no statistically significant(P=0.855, I2=0.0%, OR=2.10,95%CI：0.87to5.09). All11studies were reported recurrence rate.The meta-analysis showed a statisticallysignificant(P=0.624, I2=0.0%， OR=0.5，95%CI:0.30to0.82).In vitro experiment,afew endothelial cells degenerated after being treated with50%Glucosen for20minutes.Anhydrous ethanol and lauromacrogol treatment for5minutes, the mucosal epithelialnecrosis and shedding, the less residual portion after15minutes,20minutes mucosaldamage completely. In vivo experiment, the group A(the control group) and the groupB(50%glucose group), gallbladder volume and gallbladder wall thickness has nosignificant change (P>0.5); the group C (anhydrous ethanol group),gallbladdervolume decreased72.33%, gallbladder wall thickening of333.32%; the group D(lauromacrogol group), gallbladder volume decreased73.21%, gallbladder wallthickening of347.04%; the group E (the lauromacrogol reserved group) gallbladdervolume decreased76.21%, gallbladder wall thickening (356.41%). After pairwisecomparisons among the C、D、E groups, gallbladder volume reduction was no statisticalsignificance (P>0.05), gallbladder wall thickening was no statistical significance (P>0.05).The microscopic observation: the50%glucose group sclerotherapy was invalid;the result of both the anhydrous ethanol group and the lauromacrogol groupsclerotherapy is the same;the lauromacrogol reserved group sclerotherapy was better.Conclusions： Meta-analysis showed that complications after laparoscopicdecortication is higher than percutaneous puncture sclerotherapy, but there is nosignificant difference in recurrence rate. Sclerotherapy research by using the rabbitgallbladder instead of renal cyst, the experiments are reliable and results are similar.Lauromacrogol reserved sclerotherapy renal cysts, better than lauromacrogol andanhydrous ethanol sclerotherapy no reserved, and equally safe...