Symptomatic Simple Renal Cyst: Comparison of Continuous Negative-Pressure Catheter Drainage and Single-Session Alcohol Sclerotherapy

Department of Interventional Sonography, University Medical Center, Trnovac bb, Tuzla, TK 75000, Bosnia and Herzegovina.
American Journal of Roentgenology (Impact Factor: 2.73). 05/2008; 190(5):1193-7. DOI: 10.2214/AJR.07.2867
Source: PubMed


The purpose of this study was to evaluate whether continuous percutaneous catheter drainage with negative pressure yields better results than single-session alcohol sclerotherapy in the management of symptomatic simple renal cysts.
Eighty-five patients with 92 simple renal cysts were randomly assigned to two groups in a prospective controlled trial. One group was treated with sonographically guided continuous catheter drainage with negative pressure and the other group with single-session alcohol sclerotherapy. Patient demographics, clinical characteristics, treatment outcome, and complications were analyzed.
The initial volume of the cysts did not differ significantly between the groups, but the final volume was significantly smaller in the continuous drainage group (p = 0.026). During the 24-month follow-up period, 37 (40%) of the cysts disappeared completely: 24 (52%) of the 46 cysts in the drainage group and 13 (28%) of the 46 cysts in the sclerotherapy group (p = 0.033). In the sclerotherapy group, the probability of disappearance of the cysts was highly dependent on cyst size, being less for giant cysts (p = 0.01). Cyst size was not a significant factor in probability of disappearance in the drainage group (p = 0.15). The probability of disappearance of giant cysts (volume > 500 mL) differed significantly between the groups (p = 0.009), but there was no difference in probability of disappearance of moderately large cysts (p = 0.16). Three of 14 patients with giant cysts in the drainage group and 10 of 13 such patients in the sclerotherapy group had recurrences that necessitated additional treatment (p = 0.007). They were successfully treated with continuous catheter drainage.
Continuous catheter drainage with negative pressure is more efficient than single-session alcohol sclerotherapy in the management of giant cysts. For moderately large cysts, the two methods have similar results.

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Available from: Enver Zerem, Oct 06, 2015
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    • "In 17 patients, the cyst disappeared completely, and 83% of the patients had clinical improvement in the symptoms (2). Zerem et al. (17) treated 85 patients and 92 cysts with percutaneous ethanol sclerotherapy. Recurrence of only six cysts occurred at the 24-month follow-up. "
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    ABSTRACT: Background:The most common benign lesions of the kidney are simple cysts. They are acquired lesions and mostly affect the elderly population.Objectives:To describe the usage of choice-lock catheter and trocar technique in percutaneous renal cyst treatment and determining long-term outcomes.Patients and Methods:This retrospective study was carried out between February 2000 and July 2011. Eighty-eight cysts all of which were Bosniak type-1 cysts were selected in 75 patients. The treatment indications were flank pain, hydronephrosis and hypertension. The choice-lock catheter was used for 84 cysts with the trocar technique. Ninety-five percent ethanol was used as the sclerosing agent. Maximum volume of the injected ethanol was 175 ml. The mean follow-up time after the treatment procedure was 23 months. Sixty-four cysts were located in the cortical and 24 cysts were located at the parapelvic region.Results:Fifty-seven cysts had complete regression, while 31 cysts regressed partially. After the procedure, pain was relieved in 44 (82%) patients and the pain alleviated in four (8%). Normotension was obtained in five (62.5%) of the eight hypertensive patients and no hydronephrosis was detected in nine patients. There were no relationship between the localization and the regression rate. No major complications occurred.Conclusions:Percutaneous ethanol sclerotheraphy in simple cysts is a safe, cost-effective and minimally invasive method. We consider that this technique may be an alternative solution in the percutaneous cyst treatment.
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    • "However, treatment may be required if flank or back pain, hypertension, infection, deterioration of renal function or renal outflow obstruction occur. With new technical advances in interventional radiology, the recent trend in the treatment of symptomatic renal cysts has been more strongly toward minimally invasive methods in the form of percutaneous treatment (13). "
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