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Gao J, Zhang M, Tang J, Wang R, Chen Y, Fang Z, Zhong H. Flexible ureteroscopic incision and drainage or laparoscopic unroofing for the parapelvic renal cysts: A systematic review and meta‑analysis. Exp Ther Med 2024; 28:347. [PMID: 39006451 PMCID: PMC11240875 DOI: 10.3892/etm.2024.12636] [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] [Received: 04/12/2023] [Accepted: 02/16/2024] [Indexed: 07/16/2024] Open
Abstract
The aim of the present study was to compare flexible ureteroscopy and laparoscopy in the treatment of peripelvic renal cysts, so as to determine the best treatment method for patients with peripelvic renal cysts. A systematic search of the PubMed, EMBASE, Cochrane Library, CONAHL, Clinicaltrials.gov, Google Scholar, CNKI and WanFang DATA databases was conducted for articles published over 22 years (December 1980-December 2022) using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. By searching the database, a total of 594 studies were found, of which eight were analyzed as evidence. A total of 394 patients were included in the present study. Of these, 193 were treated laparoscopically and 201 were treated by flexible ureteroscopy. In terms of analysis results, radiation reexamination after laparoscopic therapy had a higher success rate. Ureteroscopy has advantages in the time spent in the operation, the amount of blood lost during the operation, the time to recover the anal exhaust after the operation and the length of postoperative hospital stay. There were no significant difference in postoperative recurrence or complications between the two surgical methods. After comprehensive analysis, it was considered that flexible ureteroscopy has more advantages in the treatment of peripelvic renal cyst, which is mainly manifested in the duration of operation, the total amount of blood loss during operation, the interval of recovery of anal exhaust after operation and the total length of postoperative hospital stay. It is worth further exploration and promotion.
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Affiliation(s)
- Jianguo Gao
- Department of Urology, The First Affiliated Hospital of Huzhou Normal College, Huzhou, Zhejiang 313000, P.R. China
- Department of Urology, The First Hospital of Huzhou, Huzhou, Zhejiang 313000, P.R. China
- Huzhou Key Laboratory of Precise Diagnosis and Treatment of Urinary Tumors, Huzhou, Zhejiang 313000, P.R. China
| | - Meng Zhang
- Department of Urology, The First Affiliated Hospital of Huzhou Normal College, Huzhou, Zhejiang 313000, P.R. China
- Department of Urology, The First Hospital of Huzhou, Huzhou, Zhejiang 313000, P.R. China
| | - Jianer Tang
- Department of Urology, The First Affiliated Hospital of Huzhou Normal College, Huzhou, Zhejiang 313000, P.R. China
- Department of Urology, The First Hospital of Huzhou, Huzhou, Zhejiang 313000, P.R. China
- Huzhou Key Laboratory of Precise Diagnosis and Treatment of Urinary Tumors, Huzhou, Zhejiang 313000, P.R. China
| | - Rongjiang Wang
- Department of Urology, The First Affiliated Hospital of Huzhou Normal College, Huzhou, Zhejiang 313000, P.R. China
- Department of Urology, The First Hospital of Huzhou, Huzhou, Zhejiang 313000, P.R. China
- Huzhou Key Laboratory of Precise Diagnosis and Treatment of Urinary Tumors, Huzhou, Zhejiang 313000, P.R. China
| | - Yu Chen
- Department of Urology, The First Affiliated Hospital of Huzhou Normal College, Huzhou, Zhejiang 313000, P.R. China
- Department of Urology, The First Hospital of Huzhou, Huzhou, Zhejiang 313000, P.R. China
- Huzhou Key Laboratory of Precise Diagnosis and Treatment of Urinary Tumors, Huzhou, Zhejiang 313000, P.R. China
| | - Zhihai Fang
- Department of Urology, The First Affiliated Hospital of Huzhou Normal College, Huzhou, Zhejiang 313000, P.R. China
- Department of Urology, The First Hospital of Huzhou, Huzhou, Zhejiang 313000, P.R. China
| | - Huan Zhong
- Department of Urology, The First Affiliated Hospital of Huzhou Normal College, Huzhou, Zhejiang 313000, P.R. China
- Department of Urology, The First Hospital of Huzhou, Huzhou, Zhejiang 313000, P.R. China
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Tseng WH, Hsieh CC, Huang SK, Liu CL, Lee KH, Hsieh KL, Chen ZH, Chiu AW, Li CF, Shiue YL. Advantages of retrograde intrarenal incision versus laparoscopic surgery in management of pararenal cysts: a single-center experience. Int Urol Nephrol 2024; 56:1307-1313. [PMID: 38044410 DOI: 10.1007/s11255-023-03881-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/03/2023] [Indexed: 12/05/2023]
Abstract
PURPOSE Renal cysts are typically a benign condition, and parapelvic cysts are a type of renal cyst that occur adjacent to the renal pelvis or renal sinus. Parapelvic cysts can increase the risk for injury to adjacent organs or urine leakage during laparoscopic surgery. Flexible ureteroscopes with laser assistance were used to make internal incisions in cysts. Perioperative outcomes of this method were compared with those of laparoscopic surgery. METHODS Eight-three patients, who underwent surgical treatment for renal cysts at the authors' medical center between January 2019 and June 2022, were evaluated. Two patients were excluded because they originally opted for RIRS but subsequently converted to laparoscopic surgery. Patients were divided into 2 groups based on surgery type: laparoscopic; and RIRS for internal incision. Outcomes in both groups were analyzed. RESULTS Of the 81 patients analyzed, 60 [74% (group 1)] underwent laparoscopic surgery and 21 [26% (group 2)] underwent RIRS for internal incision. The median operative durations for groups 1 and 2 were 87 and 56 min, respectively (p < 0.001). Relative to RIRS, laparoscopic surgery resulted in greater postoperative painkiller use (laparoscopic surgery versus [vs.] RIRS, 43% vs. 19%; p = 0.047). The median length of hospital stay was 2 and 1 days, respectively (p < 0.001). CONCLUSIONS RIRS demonstrated several advantages over laparoscopic surgery for the internal incision of parapelvic cysts, including shorter operative duration, shorter hospital stay, and less postoperative pain control. These findings may guide the selection of appropriate surgical approaches for patients with renal cysts.
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Affiliation(s)
- Wen-Hsin Tseng
- Institute of Biomedical Science, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
| | - Chia-Chih Hsieh
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC.
| | - Steven K Huang
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
| | - Chien-Liang Liu
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
- Division of Uro-Oncology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
| | - Kau-Han Lee
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
| | - Kun-Lin Hsieh
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
| | - Zhi-Hao Chen
- Division of Urology, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan City, 71004, Taiwan, ROC
| | - Allen W Chiu
- Department of Urology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chien-Feng Li
- Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Yow-Ling Shiue
- Institute of Biomedical Science, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan.
- Institute of Precision Medicine, College of Medicine, National Sun Yat-Sen University, No. 70, Lienhai Rd., Kaohsiung, 80424, Taiwan, ROC.
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