Treatment of Simple Renal Cyst with Percutaneous Ethanol Sclerotherapy
Keywords:
Thi-Qar, Simple Renal Cyst, Percutaneous Ethanol SclerotherapyAbstract
Purpose: To evaluate the efficacy of percutaneous sclerotherapy using 95% ethanol in the treatment of symptomatic simple renal cysts. Patients and methods: From April 2004 to July 2007, a series of 33 patients 19 males and 14 females ranging in age between 40-72 years were treated for symptomatic simple renal cysts. The cysts varied between 6.5 and 13 cm. in diameter estimated by ultrasound and from 100 to 550 ml in volume. This technique consist of ultrasound guided and local anesthesia emptying of the cyst, and slowly inserting a quality of pure 95% ethanol, equivalent to about 1\3rd of the cyst volume ( up to maximum 100 ml), into the cavity and retained for 2 h by clamping the curled drainage catheter, the clamp then released and the catheter maintained for 24-48 h, in suction, to ensure collapse of the cyst walls and avoid cyst recurrence. Results: The procedure was technically feasible and all the patients tolerate the procedure except one patient developed gross hematuria and she was excluded in the later statistical analysis. The results were evaluated by ultrasonography at 7 days postoperatively and then at 1, 3, 6, 9, months later. There was a further fallow up every 3 months lasting for 12 to 24 months. Of 33 patients treated, 21 (63.5%) patients were asymptomatic showing total remission of the cyst and did not have any recurrence. Nine patients (27%) developed marked regression with residual maximal diameter of les than 3-4 cm, which did not enlarge in subsequent check-ups and symptoms disappeared except 3 patients had persistent symptoms in spit of decrease cyst diameter <3-4 cm. We observed a recurrence which spontaneously reduce in volume, only in 3 patients one of them loss follow up, another one responding to further trial of sclerotherapy and the 3rd one treated surgically. Conclusions: The procedure was simple to apply in an out patient setting and used low cost materials, which are easily obtained. Moreover, the results appear to confirm the validity of this technique.References
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