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    Campbell 10 Edition:: Renal Cyst Disease: Indication, Procedure and Results

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    Akmal Fawzi
    Renal cyst disease can cause pain, infection, or obstruction and may require surgical intervention. Percutaneous needle aspiration is often first-line treatment for symptomatic cysts but surgery may be needed if cysts recur. Laparoscopic procedures like decortication or unroofing can resolve pain from simple cysts while complex cysts may require exploration to rule out cancer. Surgical options range from cryoablation to nephrectomy depending on cyst characteristics and location. Laparoscopic cyst treatment effectively decompresses cysts and controls pain in patients with conditions like polycystic kidney disease.

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    Campbell 10 Edition:: Renal Cyst Disease: Indication, Procedure and Results

    Uploaded by

    Akmal Fawzi
    108 views13 pages
    Renal cyst disease can cause pain, infection, or obstruction and may require surgical intervention. Percutaneous needle aspiration is often first-line treatment for symptomatic cysts but surgery may be needed if cysts recur. Laparoscopic procedures like decortication or unroofing can resolve pain from simple cysts while complex cysts may require exploration to rule out cancer. Surgical options range from cryoablation to nephrectomy depending on cyst characteristics and location. Laparoscopic cyst treatment effectively decompresses cysts and controls pain in patients with conditions like polycystic kidney disease.

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    cyst

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    Campbell Renal Cyst

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    Renal cyst disease can cause pain, infection, or obstruction and may require surgical intervention. Percutaneous needle aspiration is often first-line treatment for symptomatic cysts but surgery may be needed if cysts recur. Laparoscopic procedures like decortication or unroofing can resolve pain from simple cysts while complex cysts may require exploration to rule out cancer. Surgical options range from cryoablation to nephrectomy depending on cyst characteristics and location. Laparoscopic cyst treatment effectively decompresses cysts and controls pain in patients with conditions like polycystic kidney disease.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    108 views13 pages

    Campbell 10 Edition:: Renal Cyst Disease: Indication, Procedure and Results

    Uploaded by

    Akmal Fawzi
    Renal cyst disease can cause pain, infection, or obstruction and may require surgical intervention. Percutaneous needle aspiration is often first-line treatment for symptomatic cysts but surgery may be needed if cysts recur. Laparoscopic procedures like decortication or unroofing can resolve pain from simple cysts while complex cysts may require exploration to rule out cancer. Surgical options range from cryoablation to nephrectomy depending on cyst characteristics and location. Laparoscopic cyst treatment effectively decompresses cysts and controls pain in patients with conditions like polycystic kidney disease.

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    Campbell 10th edition:

    Renal Cyst Disease: Indication,


    Procedure and Results
    AKMAL FAWZI YUSRIL UMAM
    Introduction
    o Renal cysts are extremely common and are present in more than one third of patients more
    than 50 years old.
    o They rarely require surgical intervention, but indications include cyst-associated pain, infection,
    or obstruction.
    o Classification schema have been developed to help clinicians make determinations regarding
    management, the most popular being the Bosniak system.
    https://radiopaedia.org/articles/bosniak-classification-system-of-renal-cystic-masses
    Indications
    o First-line therapy and diagnosis of symptomatic renal cysts often involves percutaneous image-
    guided needle aspiration, with or without the use of a sclerosing agent, to prevent recurrence.
    o If recur when fluid reaccumulates, this need surgical treatment to resolve the pain.
    o In addition to causing pain, cysts may compress the renal parenchyma or other adjacent
    organs, cause ureteral obstruction and obstructive uropathy, spontaneously bleed, cause
    hypertension, or become infected.
    o Laparoscopic decortication or unroofing may be used to treat these cysts, which are typically
    simple in character.
    o Cysts with complex appearance, such as thickened septa, calcification, or enhancement
    (Bosniak class III- IV), may be explored and sampled laparoscopically to rule out renal cell
    carcinoma due to their increased risk of harboring malignancy.
    o Options include cryoablation, enucleation, partial nephrectomy, or radical nephrectomy.
    o A subset of patients with autosomal dominant polycystic kidney disease (ADPKD) may develop
    cyst-associated pain and Laparoscopic cyst decortication, marsupialization, or unroofing can be
    of benefit to these patients and success to relief pain.
    o In patients with end-stage renal disease, bilateral synchronous laparoscopic nephrectomy may
    be performed in patients with enlarged, symptomatic, or infected kidneys.
    Procedures
    o Depending on cyst location, a transperitoneal or retroperitoneal approach may be used as
    previously described.
    o Intraoperative ultrasonography may be used to identify the cyst or cysts in question.
    o It is usually easier to dissect out the cyst wall before evacuating fluid.
    o If no evidence of malignancy is seen, the remaining cyst wall may be fulgarated with either
    electrocautery or the argon beam coagulator.
    o If malignancy is noted, extirpative surgery or cryoablation may be used to treat the remainder
    of the lesion.
    oWhen treating central or perihilar cysts, it may not be feasible to remove a large portion of the
    cyst wall. In these cases, it is helpful to place a pedicle of autologous fat into the defect to act as
    a wick.
    Results
    o Laparoscopic treatment of symptomatic renal cysts has been found to be effective in both
    decompression and pain control.
    o In patients with ADPKD, additional benefits of cyst decortication have been noted, including
    decreased blood pressure.
    o the reported incidence of renal cell carcinoma in cystic lesions is between 3% and 20%.
    THANK YOU

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