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Mao Y, Li W, Da J, Xu M, Wang Y, Gu Y, Pan W, Wang Z. Analysis of the effect of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts. Asian J Urol 2023; 10:172-176. [PMID: 36942122 PMCID: PMC10023544 DOI: 10.1016/j.ajur.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 02/19/2021] [Accepted: 06/25/2021] [Indexed: 10/20/2022] Open
Abstract
Objective To explore the efficacy, safety, and feasibility of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts. Methods From September 2012 to February 2019, a total of 18 patients, aged from 28 to 62 (mean±standard deviation [SD]: 46.50±9.14) years, were diagnosed with parapelvic renal cysts and treated by holmium laser flexible ureteroscopic intrapelvic drainage. There were 10 males and eight females. All of the parapelvic renal cysts were unilateral, and two cases were complicated with pyelolithiasis. The diameters of the cysts ranged from 4.1 cm to 8.2 cm. Results All the patients completed the operation successfully in one stage without conversion to open surgery; in two cases, it was difficult to find the cysts during the operation, and the localization was completed by B-ultrasound and percutaneous injection of methylene blue. The mean operative time was 33.89 (SD: 9.68; range: 22-54) min, and the mean hospitalization time was 2.67 (SD: 0.91; range: 2-5) days. Three months and 6 months of follow-up were performed after surgery. The cysts disappeared in 13 (72%) cases, and the diameter of the cysts in five (28%) cases decreased by more than 50%. Conclusion Holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts is simple, safe, and effective, and can be used as the first choice for the treatment of parapelvic renal cysts.
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Yang WZ, Sun YF, Cui ZY, Ma T. Single-Port Percutaneous Nephroscopy combined with GreenLight Laser in Simple Renal Cyst. Pak J Med Sci 2020; 36:1585-1589. [PMID: 33235579 PMCID: PMC7674897 DOI: 10.12669/pjms.36.7.2322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: To explore the therapeutic effect of percutaneous nephroscopy combined with Green Light laser on simple renal cyst. Methods: A retrospective analysis was conducted to review the clinical data, surgical procedures, intraoperative bleeding, postoperative adverse reactions, and length of stay of 32 patients who had been admitted to Affiliated Hospital of Hebei University from January 2018 to February 2019. All patients had been diagnosed with simple renal cyst by imaging examination and met the surgical indications for single-port percutaneous nephroscopy combined with GreenLight laser for unroofing and decompression of the renal cyst. Among the 32 patients, there were 18 males and 14 females, with 15 cases on the left and 17 on the right. The patients aged 38 to 62 years old, with an average of 45 years old. Thirteen cases were hospitalized mainly due to complaint of lumbar pain, and 19 cases were admitted after a renal cyst was found by physical examination. The diameter of the cyst ranged from 4.2 to 9.1 cm, with an average of 6.1 cm. A percutaneous nephroscopic channel was established during the surgery. Once a nephroscope was placed into the cyst, GreenLight laser (energy of 80W) was used to remove the free cyst wall 0.3cm from the renal parenchymal margin under direct vision. After the incision margin was observed with no obvious exudation under microscope, the cyst wall was removed through the channel and sent for pathological examination. A drainage catheter was placed near the cyst cavity. Results: All the 32 patients were successfully operated, without transition to laparoscopic and open surgery. The operations took 30 to 62 minutes, with an average of 45 minutes. The intraoperative bleeding ranged from three to 14 ml, with an average of 10 ml. No adverse events such as postoperative infection, fever, or active bleeding occurred. The drainage catheters were removed one to three days after operation, with an average of 1.5 days after operation. The drainage volume was 20 to 55 ml, with an average of 35 ml. No obvious liquid extravasation was seen in all cases. The length of stay after operation ranged from three to five days, with an average of 3.5 days. Postoperative pathological reports all suggested renal cyst wall. The patients were followed up for six months, and no cyst recurred. Conclusions: Single-port percutaneous nephroscopy combined with Green Light laser could provide significant clinical effect in treating simple renal cyst with minimal trauma.
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Affiliation(s)
- Wen-Zeng Yang
- Wen-zeng Yang, Department of Urology, Affiliated Hospital of Hebei University, Baoding, Hebei, 071030, P. R. China
| | - Yun-Fei Sun
- Yun-fei Sun, Medical College of Hebei University, Baoding, Hebei 071000, P. R. China
| | - Zhen-Yu Cui
- Zhen-yu Cui, Department of Urology, Affiliated Hospital of Hebei University, Baoding, Hebei, 071030, P. R. China
| | - Tao Ma
- Tao Ma, Department of Urology, Affiliated Hospital of Hebei University, Baoding, Hebei, 071030, P. R. China
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Khoder WY, Grabbert M, Sigle A, Astheimer S, Vallo S, Gratzke C. Retrospective Evaluation of the Clinical Values of Minimally Invasive Marsupialization of Symptomatic Giant Renal Cysts. J Laparoendosc Adv Surg Tech A 2020; 31:279-283. [PMID: 33074753 DOI: 10.1089/lap.2020.0415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: To evaluate the indication and benefit of minimally invasive laparoscopic marsupialization (MIS) of symptomatic giant renal cysts. Materials and Methods: Sixty-four consecutive patients who underwent MIS for large renal cysts (Bosniak I; 4 × 5-16 × 12 cm) by one surgeon were included in the study. Presenting symptoms were renal pain (100%), associated with hypertension (28%), renal dysfunction (4.7%), hematuria (4.7%), ureteropelvic junction obstruction (UPJO) (7.8%), ipsilateral urolithiasis (4.7%), polycystic kidney (6.3%), adrenal cyst (1.6%), and retroperitoneal cysts (1.6%). Seven patients with peripelvic cysts and previous retroperitoneal operations were treated by a laparoscopic approach; all other patients underwent retroperitoneoscopic marsupialization. Single-port retroperitoneoscopy was performed in 4 patients. Follow-up included clinical examination, abdominal ultrasound, and computed tomography scan. Postoperative radiologic success was defined as a minimum of 50% in size reduction and no recurrence. Results: Mean patients' age was 46 (21-65) years. All procedures were successfully completed without conversion or revision. Mean operative time was 55 (40-85) minutes with a mean hospital stay of 3 days. All patients underwent uneventful postoperative recovery. Observed minor complications (transitory fever/pain) were found in 4 patients during the first postoperative month. Median follow-up was 12 months (10 months-2 years). About 98.5% of patients reported of no relevant postoperative pain. A relief from UPJO and hematuria was achieved in 100% of patients. Ten patients with known hypertensive disease (55.6%) had a significant reduction of mean blood pressure resulting in a reduction of antihypertensive medication. Ureterorenoscopic stone extractions were performed successfully afterward. No cyst recurrences were detected during the follow-up period. Conclusion: Treatment indications for symptomatic renal cysts could include not only symptoms but also associated diseases like UPJO and hypertension. Retroperitoneoscopic MIS may be curative for these cyst-associated pathologies. The feasibility, safety and efficacy of these techniques could be demonstrated.
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Affiliation(s)
- Wael Y Khoder
- Department of Urology, Freiburg University Hospital, Freiburg, Germany
| | - Markus Grabbert
- Department of Urology, Freiburg University Hospital, Freiburg, Germany
| | - August Sigle
- Department of Urology, Freiburg University Hospital, Freiburg, Germany
| | - Sophie Astheimer
- Department of Urology, Freiburg University Hospital, Freiburg, Germany
| | - Stefan Vallo
- Klinik für Urologie, Hochtaunus-Kliniken, Bad Homburg vor der Höhe, Germany
| | - Christian Gratzke
- Department of Urology, Freiburg University Hospital, Freiburg, Germany
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Zhang X, Cao D, Han P, Ren Z, Wang J, Wei Q. Aspiration-sclerotherapy versus laparoscopic de-roofing in the treatment of renal cysts: which is better? BMC Nephrol 2020; 21:193. [PMID: 32448166 PMCID: PMC7245882 DOI: 10.1186/s12882-020-01832-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 04/27/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To compare the clinical efficiency between aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) in the management of renal cysts through meta-analysis of comparative studies. METHOD A comprehensive literature search was performed by PubMed, MEDLINE, Ovid and Web of Science for relevant studies published up to January 2020. The statistical analyses were conducted with Review Manager 5.3.0 and Stata 15.1. The sensitivity analysis was also carried out to confirm the reliability of this Meta-analysis. RESULTS Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that LD group was superior in symptomatic successful rate [Odds Ratio (OR): 0.28; 95%Confidence Interval (CI): 0.09 to 0.86; P = 0.03), radiological successful rate (OR: 0.06; 95%CI: 0.02 to 0.15; P < 0.01) and recurrence rate (OR: 6.08; 95%CI: 2.81 to 13.15; p < 0.01). Nevertheless, AS group had shorter treatment time [Mean Difference (MD):-51.10; 95% CI:-73.01 to - 29.20; p < 0.01]. No statistically significant difference was showed in the rate of complications (OR: 3.19; 95% CI: 0.39 to 25.88; P = 0.28). CONCLUSIONS In our meta-analysis, LD had higher symptomatic successful rate, radiological successful rate as well as lower recurrence rate than AS, while the treatment time was longer.
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Affiliation(s)
- Xueling Zhang
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
| | - Dehong Cao
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, 61000, People's Republic of China
| | - Peizhen Han
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
| | - Zhengju Ren
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
| | - Jia Wang
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China.
| | - Qiang Wei
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China.
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Choi JD, Yoo TK, Kang JY, Moon KT, Kim JH, Ahn SH, Lee JH, Cho JM. A Comparative Study of Percutaneous Aspiration with Sclerotherapy and Laparoscopic Marsupialization for Symptomatic Simple Renal Cysts. J Laparoendosc Adv Surg Tech A 2020; 30:514-519. [PMID: 31928507 DOI: 10.1089/lap.2019.0745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Percutaneous aspiration with sclerotherapy (PAS) and laparoscopic marsupialization (LM) are minimally invasive treatment modalities for renal cysts. We aimed to compare the efficacy and cost/effectiveness of LM and PAS for the treatment of simple symptomatic renal cysts. Methods: Data were prospectively collected from three health care institutions in which 80 patients with symptomatic simple renal cysts underwent a single session of PAS with 95% ethanol (PAS group, n = 40) or underwent LM under general anesthesia (LM group, n = 40) between March 2012 and May 2016. We compared the patient profile, duration of procedure, duration of hospital stay, radiological and symptomatic success rates, treatment costs, and incidence of complications between the two groups. Results: At the 6-month follow-up, the radiological success rate in the LM group was significantly greater than that in the PAS group (97.5% versus 60%; P < .001). The symptomatic success rate was comparable in the two groups (95% versus 90%; P = .675). The treatment failure rate did not significantly differ between the two groups (5.0% versus 17.5%, P = .154). The mean total cost in the PAS and LM groups was 1256 USD and 2343 USD, respectively (P = .001). No significant between-group difference was noted regarding the overall complication rate (P = .615). Conclusions: Both LM and PAS are effective and safe procedures for the treatment of symptomatic simple renal cysts. A single session of PAS seems to be a cost-effective method for the management of symptomatic simple renal cysts.
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Affiliation(s)
- Jae Duck Choi
- Department of Urology, Eulji Genaral Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Tag Keun Yoo
- Department of Urology, Eulji Genaral Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Jung Yoon Kang
- Department of Urology, Eulji Genaral Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Kyong Tae Moon
- Department of Urology, Eulji Genaral Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Jung Hoon Kim
- Department of Urology, Hanil General Hospital, KEPCO Medical Foundation, Seoul, Republic of Korea
| | - Seung Hyun Ahn
- Department of Urology, Hanil General Hospital, KEPCO Medical Foundation, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Urology, National Police Hospital, Seoul, Republic of Korea
| | - Jeoung Man Cho
- Department of Urology, Eulji Genaral Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
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Hu J, Dirie NI, Yang J, Xia D, Lu Y, Yu X, Wang S. Percutaneous ureteroscopy laser unroofing-a minimally invasive approach for renal cyst treatment. Sci Rep 2017; 7:14445. [PMID: 29089521 PMCID: PMC5663957 DOI: 10.1038/s41598-017-14605-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 10/12/2017] [Indexed: 11/24/2022] Open
Abstract
Most simple renal cysts rarely require therapy. When it grows to such a large size, regardless of the presence of symptomatology, surgical intervention is required. In this study, we explored a new approach called percutaneous ureteroscopy laser unroofing for treatment renal cysts and evaluated its safety and efficacy. 71 simple renal cyst patients with surgical indications were enrolled, including 6 patients with a peripelvic cyst and 5 patients coexisting ipsilateral calculi. Under ultrasound guidance, an eighteen-gauge needle was placed inside the cyst cavity, and a guidewire was introduced followed by sequential dilation up to 28 F. The extra-parenchymal portion of cyst wall was dissociated and incised using either a Thulium or Holmium laser, and a pathological examination was performed. Renal calculi were treated simultaneously. For peripelvic cyst patients, one end of a double-J stent was inserted into the cyst cavity to prevent auto-closure. Mean of 11.7 months follow-up, the results showed that the cyst was completely resolved in 53 patients, its size was reduced to less than 50% in 15 patients, and treatment failed in only 3 anterior cyst patients, suggesting that percutaneous ureteroscopy laser unroofing is an effective and less invasive alternative for treatment of renal cysts in selected patients.
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Affiliation(s)
- Jia Hu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Najib Isse Dirie
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ding Xia
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yuchao Lu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao Yu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Srivastava A, Sureka SK, Vashishtha S, Agarwal S, Ansari MS, Kumar M. Single-centre experience of retroperitoneoscopic approach in urology with tips to overcome the steep learning curve. J Minim Access Surg 2016; 12:102-8. [PMID: 27073300 PMCID: PMC4810941 DOI: 10.4103/0972-9941.178517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
CONTEXT: The retroperitoneoscopic or retroperitoneal (RP) surgical approach has not become as popular as the transperitoneal (TP) one due to the steeper learning curve. AIMS: Our single-institution experience focuses on the feasibility, advantages and complications of retroperitoneoscopic surgeries (RS) performed over the past 10 years. Tips and tricks have been discussed to overcome the steep learning curve and these are emphasised. SETTINGS AND DESIGN: This study made a retrospective analysis of computerised hospital data of patients who underwent RP urological procedures from 2003 to 2013 at a tertiary care centre. PATIENTS AND METHODS: Between 2003 and 2013, 314 cases of RS were performed for various urological procedures. We analysed the operative time, peri-operative complications, time to return of bowel sound, length of hospital stay, and advantages and difficulties involved. Post-operative complications were stratified into five grades using modified Clavien classification (MCC). RESULTS: RS were successfully completed in 95.5% of patients, with 4% of the procedures electively performed by the combined approach (both RP and TP); 3.2% required open conversion and 1.3% were converted to the TP approach. The most common cause for conversion was bleeding. Mean hospital stay was 3.2 ± 1.2 days and the mean time for returning of bowel sounds was 16.5 ± 5.4 h. Of the patients, 1.4% required peri-operative blood transfusion. A total of 16 patients (5%) had post-operative complications and the majority were grades I and II as per MCC. The rates of intra-operative and post-operative complications depended on the difficulty of the procedure, but the complications diminished over the years with the increasing experience of surgeons. CONCLUSION: Retroperitoneoscopy has proven an excellent approach, with certain advantages. The tips and tricks that have been provided and emphasised should definitely help to minimise the steep learning curve.
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Affiliation(s)
- Aneesh Srivastava
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjoy Kumar Sureka
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Saurabh Vashishtha
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shikhar Agarwal
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Md Saleh Ansari
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Manoj Kumar
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Treatment of renal parapelvic cysts with a flexible ureteroscope. Int Urol Nephrol 2014; 46:1903-8. [DOI: 10.1007/s11255-014-0741-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 05/08/2014] [Indexed: 10/25/2022]
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Yang D, Xue B, Zang Y, Liu X, Zhu J, Chen D, Tao W, Shan Y. A modified laparoendoscopic single-site renal cyst decortication: single-channel retroperitoneal laparoscopic decortication of simple renal cyst. J Laparoendosc Adv Surg Tech A 2013; 23:506-10. [PMID: 23597186 DOI: 10.1089/lap.2012.0411] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Laparoscopic renal cyst decortication often uses three-port incisions or single-port incision with three or four channels (laparoendoscopic single-site surgery). This article introduces a modified laparoendoscopic single-site surgery for the treatment of simple renal cysts: single-channel retroperitoneal laparoscopic decortication (SCRL) of a simple renal cyst. PATIENTS AND METHODS From January 2008 to December 2011, either SCRL or standard three-port-incision retroperitoneal laparoscopic decortication (SRL) was performed for the treatment of a simple renal cyst. The SCRL procedure was as follows. The patients were placed in the lateral decubitus position. A 1.2-cm horizontal skin incision was made over the midaxillary line, 3 cm above the iliac crest. The retroperitoneum working space was established. A 10-mm operative laparoscope, which is similar to a nephroscope, was introduced into the retroperitoneum cavity through a 1.1-cm port. The cyst was exposed and then sutured to help to suspend the cyst wall so that the cyst could be decorticated easily. Perioperative and follow-up data from SCRL and SRL were collected retrospectively. RESULTS Based on the cyst location as the major selection criterion, 92 cases were enrolled for further analysis. Of these, 38 patients were treated with SCRL, and 54 patients were subjected to SRL. No SCRL was converted to SRL, and no SRL was converted to open surgery. The operation time and the drain tube removal time in these two approaches were similar (P>.05), but the average duration of hospital stay in the SCRL group was shorter (P=.02). Six months after the surgery, renal ultrasound results showed that the diameter of the cyst in these two groups also had no significant difference (P>.05). CONCLUSIONS With appropriate selection of patients, the SCRL approach has the same efficacy with better cosmesis compared with SRL.
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Affiliation(s)
- Dongrong Yang
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China
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10
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Chen Z, Chen X, Wu ZH, Luo YC, He Y, Li NN, Xie CQ, Lai C. Feasibility and Safety of Retroperitoneal Laparoendoscopic Single-Site Dismembered Pyeloplasty: A Clinical Report of 10 Cases. J Laparoendosc Adv Surg Tech A 2012; 22:685-90. [PMID: 22845552 DOI: 10.1089/lap.2012.0164] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Zhi Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xiang Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Zhong-Hua Wu
- Department of Urology, Hubei Provincial Corps Hospital, Chinese People's Armed Police Forces, Wuhan, Hubei Province, China
| | - Yan-Cheng Luo
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yao He
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Nan-Nan Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Chao-Qun Xie
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Chen Lai
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
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